NHS Direct: managing demand for primary care?

Mark, Annabelle L. and Shepherd, Ifan D. H. (2007) NHS Direct: managing demand for primary care? The International Journal of Health Planning and Management, 19 (1) . pp. 79-91. ISSN 1099-1751 [Article] (doi:10.1002/hpm.746)

Download (109kB) | Preview


This paper considers how NHS Direct is affecting demand for primary care in particular out-of-hours services from GPs. This is reviewed through a 3-year study of NHS Direct and HARMONI, the integrated telephone health helpline based in West London. It describes the policy background and development of the services on the site, and some of the outcomes of the HARMONI commissioned research to answer the question Has NHS Direct increased the workload for HARMONI doctors?.
The research adopted both a qualitative and quantitative approach using cross-sectional and longitudinal analysis of the data collected. The analysis of the data reveals the issues as both complex and dynamic in nature. The research shows that while there has been no significant change to the total volume of activity, changes within patient groups notably the elderly and children, and in individual GP practices may be significant. In addition, the changes in organizational arrangements may influence significant changes in referral patterns such as GP out-of-hours visits. This was confirmed in the interview data indicating a link between the change in nurses' role from gatekeeper to patient advocate, which happened when they ceased to be employees of the part-time co-op and began to work instead for the 24 hours, 7 days a week NHS Direct service.
The conclusions drawn are that behavioural and organizational changes are at least as significant as the evidence-based computerized decision support software in changing the demand for primary care. Further evidence cited is that a different demand pattern of calls was experienced by those local GPs not integrated into out-of-hours provision at NHS Direct West London at the time of the study. Copyright © 2004 John Wiley & Sons, Ltd.

Item Type: Article
Research Areas: A. > Business School
A. > Business School > Leadership, Work and Organisations
ISI Impact: 0
Item ID: 576
Notes on copyright: Pre-refereed version as allowed by publisher.
Useful Links:
Depositing User: Repository team
Date Deposited: 28 Nov 2008 12:36
Last Modified: 23 Jun 2021 06:25
URI: https://eprints.mdx.ac.uk/id/eprint/576

Actions (login required)

View Item View Item


Activity Overview

Additional statistics are available via IRStats2.