NHS – not so Direct

Society is changing every minute of every day. But since the arrival of the ConDem Government this change seems to have intensified. I have written before in this blog about the phenomenon of waking up to find another quango or body has been disestablished. Cuts are being made and they are very real and very deep.

We have already seen the back of the Audit Commission, the Development Agencies and a whole host of other smaller agencies. There is not a public sector employee in the land who doesn’t wake in the morning without a nagging concern that they may suddenly find they are out of a job, and that the organisation they have devoted years to has suddenly disappeared.

The latest victim of the cuts is NHS Direct which although it has an estimated 14,000 people a day phoning it for help or advice – rather than going to the doctors or hospital – is now to be axed. We need to remember why it was established, which was to ease the pressure on overstretched hospitals and doctors. In short, it was supposed to be a way to take some of the pressure off the health service. In the 12 years since it was created it has developed as a national service.  So, why does it need to be cut now? The easy answer is to save money. But it must be more than that because the service is expected to be replaced, which means that it is needed.

The end of NHS Direct

NHS Direct

According to the NHS Direct’s current Chief Executive Nick Chapman the new 111 service will be easier to remember. Surely that isn’t the best reason to make such a big change to the facility. As we will be exchanging one phone-line staffed by a number of experts, with another that is staffed with slightly fewer experts. It will save some money but the handover will be the most expensive telephone number change for many years.

In an era of the ‘big society’ why isn’t such a decision being made based on the view of the users? It should be people who say what works and why and how they would like to see things improved. Isn’t that the modern way that Cameron and Clegg have talked about on many, many occasions? From that point the service can be redesigned by the very people it is created to help. And in that redesign the savings will be easy to extract.

In 2010 there must be more to providing advice than just having a telephone helpline. Where are the Internet facility and the use of social networks? Will we just see a reskinning of the existing NHS direct website?

The time is obviously right to have a complete rethink about how the advice is provided and made available to people. There will be people who want to get information via text, through Facebook or Twitter rather than even to go on a website.  This shouldn’t be a discussion about the future of the telephone helpline but rather a debate about how this support and information can, and should, be provided.

If we had the views of the public then defining the elements of the service would be easy to establish. The users could say what they felt worked from the existing service and that could be used as the foundation to build a new service. But even without the public involvement there is a whole host of information about good practice that shows the way a total advice service can be provided using a range of media.

Let us hope that someone involved in this system is already identifying what can be done.


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