By Gareth Iacobucci
GPs have raised concerns over plans by NHS Direct to re-locate hundreds of nurse advisers from its call centres to drive down costs.
The organisation is seeking to decentralise the service by having at least 100 home workers in place by next March 2011, in the first stage of a plan to increase productivity and make cuts of £28 million.
The plans come amid growing doubts over the long-term future of NHS Direct, following the introduction of the new 111 number for non-emergency urgent care, which is likely to supersede the current service when rolled out across England.
NHS Direct said the plans, outlined in its latest board papers, could yield ‘significant financial benefits’, and would would generate savings through increased productivity and reduced turnover of staff.
But GP leaders questioned whether the shift would actually save money, and said it could increase the risk of a breach in patient confidentiality.
The plans are have been piloted in Plymouth and Milton Keynes, with nurse advisers saying they became more ‘autonomous’ and were able to ‘focus fully on the calls they are taking’ due to a reduction in background noise.
It said a survey of 500 hundred NHS Direct nurse advisers provided evidence of staff support for the move, with 85% interested in permanent home working.
A spokesperson from NHS Direct said the plan would not reduce their infrastructure costs, but would generate savings over time.
‘Homeworking will improve the quality of our service and will produce savings through increased productivity, reduced sickness absence and reduced turnover of staff.
‘No patient data is held or stored in the home environment, and cannot be downloaded or exported from the computer or printed out. Patient data is only available to the nurse when they are working and logged on, and the nurses work under a strict confidentiality protocol in keeping with their professional status,’ she said.
Dr Andrew Mimnagh, chair of Sefton LMC, and a GP in Waterloo, Merseyside, said the cost-cutting of the service was ‘long overdue’, but questioned whether the move would save cash, and warned it could also increase risks to patient confidentiality.
He said: ‘It strikes me as re-arranging the deckchairs on the Titanic. Leaving aside what value NHS Direct provides, I can only see it costing more. How are they going to make it work at home? It is a massive infrastructure.’
He added: ‘There’s also a small but increased risk of patient confidentiality leaks. If you’re in a centre and leave your smart card in, there are other people there, but if you are at home, and you answer the door for example, there is a risk.’
NHS Direct is planning to re-locate more staff to home working arrangements Results of home-working pilot
• the number of patients nurses were able to speak to per hour increased by 25%
• the time the nurses were available to answer calls and spend with patients rose by over 10%
• the number of calls completed within NHS Direct (where patients are given self-care advice) rose from 60% to over 80%
Source: Pilot with nine nurse advisers, NHS Direct