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NHS Direct bounces callers back to GPs

GPs have criticised NHS

Direct for being 'too safe' and referring too many callers to practices or out-of-hours co-operatives.

The attack came after a quarterly review of the nurse triage service's performance showed it referred more than a quarter of callers to see a GP within four hours.

A further 10 per cent were told to see a GP within 12 hours and 16 per cent were given a non-urgent referral to see their GP the next day or later.

The figures for cases requiring GP attention are up to 50 per cent higher than those where co-ops employ their own nurses to triage calls.

GP co-ops said patients were 'bouncing back' to be dealt with by GPs because they were not satisfied with NHS Direct's service.

Dr Graeme Kelvin, chair of Suffolk Doctors on Call, said two-thirds of callers who rang the co-op but chose an NHS Direct option from the initial telephone menu were later referred back to the GP service.

'The difference is NHS Direct works to extremely strict, safe and cautious protocols, whereas doctors run with risk,' he said.

'NHS Direct works continually to improve the software but we fear it may be becoming even more conservative. It begs the question ­ what is the point of talking to an NHS

Direct nurse?'

Les Yeates, chief executive of Solidoc in Solihull, West Midlands, said NHS Direct was referring too many calls inappropriately to the co-op.

He said the co-op's nurses were able to deal with one-third of cases referred by NHS Direct for GP's attention by giving advice. Mr Yeates added: 'Why can our nurses do what theirs can't?'

Jane Harris, nurse manager at Sussex Doctors on Call, said it passed only 30 per cent of callers to GPs.

NHS Direct's statistics showed half of callers displaying symptoms were referred to a GP, either as urgent or non-urgent cases. 'The difference is we don't use algorithms ­ they don't work,' said Ms Harris.

The NHS Plan target is

for NHS Direct to be a

'one-stop gateway to out-of-hours health care' by December 2004.

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