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Gold, incentives and meh

GPs force ministers to scale down NHS Direct

The Government is planning to scale down massively the role of NHS Direct in out-of-hours care and hand back power to GP co-operatives.

Pulse has learned that ministers are considering an announcement next month to transfer call triage back to GPs during peak times.

The crisis move comes amid mounting concerns over patient safety and NHS

Direct's capacity.

It will represent a humiliating climbdown for the Department of Health, which has boasted that NHS Direct nurses will be the first point of contact for all out-of-hours calls by the end of next year.

A senior GP adviser to the department told Pulse last week the Government had recognised NHS Direct did not have the capacity to meet the deadline.

Dr Ian Trimble, co-author of the Carson report on the future of out-of-hours care, expressed concern about inappropriate referrals, call lengths and the number of primary care centre visits recommended. 'The underlying problem is with the software,' said Dr Trimble, a GP in Nottingham and chair of Nottingham City PCT.

Shropshire Doctors on Call (Shropdoc) last week became the latest pilot site to threaten to sever all links with NHS


It set a June deadline for the Government to pump in more cash to improve NHS Direct's performance after a stream of complaints from GPs and patients.

Dr Steve Hugh, medical manager at Shropdoc, said NHS Direct had failed to diagnose a hip fracture, and on two occasions did not call ambulances for patients with chest pain.

Dr David Lloyd, external relations director at west London co-op Harmoni, a first-wave pilot site, said NHS

Direct would never have the capacity to handle the volume of calls demanded by co-ops.

He added: 'That has not been officially said yet but everyone knows it.'

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