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NHS Direct role is fundamentally flawed

I am not at all surprised the Government is planning to scale down the role of NHS Direct (News report, February 3). In our co-operative many of my colleagues have experienced examples of NHS Direct generating consultations that otherwise would not have occurred and were not necessary.

Unfortunately, once the triage nurse has informed a patient they 'need to see a doctor' it can make the task of effectively managing even a simple problem over the phone well nigh impossible. Even worse, we have experienced a few cases of ambulances being sent to non-urgent problems.

NHS Direct admits there is a problem with the software. It is far too conservative and puts too much emphasis on individual symptoms without being able to take account of the overall clinical picture. As the service is protocol-driven there is little or no room for clinical judgment.

Our co-op has an excellent call-handling service that allows duty doctors to triage calls very effectively. Patient and doctor satisfaction levels are high and we already meet nearly all of the out-of-hours quality standards.

However, we are faced with the prospect of an enforced linkage with NHS Direct that will increase work, reduce the quality of service provision, reduce patient satisfaction and increase costs!

The plan to make NHS Direct the sole gateway for accessing out-of-hours care and remove the ability of GPs to determine whether or not a consultation is necessary is fundamentally flawed. Let us hope the Department of Health has now seen sense and will allow GPs to make the decision of whether a patient needs to be seen and leave NHS Direct as an occasionally useful supplementary advice line.

Dr Philip Rathbone

GP Principal

Melton Rutland & Harborough Doctors On Call chair

Long Clawson, Melton Mowbray

Leicestershire

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