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NHS Direct triage dropped

The Government has further backtracked from its plans for NHS Direct to handle all out-of-hours calls after admitting the service could not cope with future demand.

Department of Health guidance to PCTs on implementing the out-of-hours opt-out in the new contract states that co-ops and deputising services will not have to use NHS Direct to triage their calls.

Instead, out-of-hours providers can use their own nurses and use NHS Direct to take basic clinical and demographic details and pass them on.

The move comes after consistent complaints from GP co-ops about NHS Direct's service and a Commission for Health Improvement report which found it was missing key targets.

Ministers have already put back by two years to the end of 2006 a deadline for NHS Direct to act as a first point of contact for out-of-hours calls.

A Government review of NHS Direct in April also devolved to PCTs the power to decide whether integration between out-of-hours providers and NHS Direct goes ahead.

GP co-ops said the department's latest concession would help trusts develop local models for out-of-hours services using co-ops' existing nurse triage systems.

Dr Alex Yeates, director of Medway Doctors on Call, said the Government was 'at last seeing sense'.

'They are looking at ways of getting best value for money and it may not be giving that money to NHS Direct. It could be using co-ops or commercial providers.'

Dr Richard Usher, medical director of Macclesfield GP Co-operative, said co-ops were happier using their own nurses to triage because the service could remain local.

'I know from talking to a number of co-ops that they are still unhappy with the quality of the outcomes of NHS Direct calls,' he said.

Dr Rob Ferns, a director of Sussex Doctors on Call, said the co-op would also prefer to use its own triage service.

The Department of Health maintained that its December 2006 target for NHS Direct to be 'a single point of contact' for out-of-hours calls remained. A spokesman said: 'The commitment remains that NHS Direct will support clinically integrated out-of-hours services.'

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