University of Leicester eBulletin

NHS Direct Largely Used By 
30-60 Year Olds and Young Parents

September 2003

The pioneering NHS Direct service, which gives medical advice to patients over the telephone, is used it seems largely people aged between 30 and 60, says new independent research funded by the Economic and Social Research Council (ESRC). The nurse-led service also appeals in particular to two distinct groups: men, who often find the NHS unfriendly, and new parents, says the research, which is part of the ESRC Innovative Health Technologies Programme.

The findings from this project will be announced today at the University of Leicester where the Management Centre has organised a conference entitled NHS Direct: Empowerment or Dependency? 

Men use NHS Direct for themselves, and, perhaps more importantly, to enquire about healthcare for others, partners, children, elderly parents, for instance. The fact that the service is available round the clock and that it is accessed by telephone may mean that men find it attractive since it interferes much less with paid work than visits to the doctor. 

New parents, meanwhile, find they are more comfortable in asking for advice from nurses staffing NHS Direct than going to their GP who might see the problem as trivial. These are people who worry that they could be wasting NHS resources by going to their doctor. People least likely to use NHS Direct are over 60s, along with under 20s. 

NHS Direct users say that they find the system friendly and helpful. This is in contrast to their experiences with the health service as a whole. One of the biggest fears of NHS Direct’s satisfied customers is that it will become a victim of its own success and become like the rest of the NHS. 

The research reveals that there is indeed a threat to the satisfaction ratings with staff experiencing a tension between answering telephone calls as quickly as possible while also wanting to spend as much time with callers as they think is necessary to do the job properly.

NHS Direct was launched in1998 as a service which would take pressure off GPs and accident and emergency services and so save resources. Other considerations stemmed from the desire to give people more control over their health. It was “a new service to match the new citizen”, says Professor Gerard Hanlon. By encouraging callers to explain their symptoms, they would become more confident about questioning the experts, for instance, and come to manage their health more successfully. As it is, some people, dissatisfied with their GP or hospital experience, have used NHS Direct to get another stab at diagnosis by getting another opinion. 

But such confidence is not the norm. The research found that users often behaved in very traditional ways in their conversations with the nurses. “Within the calls, professional power is still strong and generally shapes the conversation”, says Professor Hanlon.

The NHS Direct service is under pressure from managers to operate in a more standardised form which is not always welcomed by nurses. The set up is similar to a call centre but the system has not suffered the sweat shop pressure of many such centres. It might even be that caller and nurse are currently less pressured than in other NHS settings like the GP surgery. Nurses and callers cannot see each other, or the queues of people waiting for attention. Nurses are still working to their belief that they must give time to the caller and explain everything in as much depth as possible.

The research project was conducted in two large NHS Direct telephone centres. The bulk of the callers to these centres (who had to agree to participate in the research and therefore may not be wholly representative of the service) were between 30 and 60 years old, white, and middle class. 

For further information, contact Professor Hanlon, telephone: at University of Leicester, 0116 252 3958 or 0116 252 5520

OR Iain Stewart or Rachel Blackford in ESRC External Relations on 01793 413032/413126


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Last updated: September 2003
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