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Gold, incentives and meh

GPs face legal risks as skill mix scheme is rushed through

One caller in eight to NHS Direct is advised to visit their GP or another health professional 'unnecessarily', a Government-commissioned evaluation has found.

The research into the appropriateness of guidance given by the nurse triage service also found one in 10 patients ignored advice given to them.

The findings add to GP criticisms of NHS Direct, which has previously been found to duplicate work done by existing NHS services and failing to hit hard-to-reach groups.

Report author Dr James Munro, senior clinical lecturer at the University of Sheffield, said the results showed NHS Direct was placing unnecessary burdens on other parts of the health service.

'What this shows is that the service is being safe and cautious, but maybe a little over-cautious,' he said.

'The challenge now is to make sure these unnecessary contacts are reduced while ensuring that patient safety isn't compromised.'

Dr David Lloyd, a director of Middlesex GP co-operative Harmoni, which uses NHS Direct to triage calls, said

the fact the service was nurse-led contributed to the findings.

'I believe this figure can be brought down by integrating NHS Direct with other organisations,' said Dr Lloyd, a GP in Harrow.

The Government last year delayed the deadline to integrate the NHS Direct service with other out-of-hours pro-viders due to concerns over


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