Men and older people are less likely to use NHS Direct

Editor—Last year George discussed the underuse of NHS Direct by certain groups in society.¹ Other investigators have also identified variations in the use and awareness of the service.²,³ We examined this issue by conducting a survey of people in general practice waiting rooms at two surgeries in Southwark, London. We surveyed 207 people aged 13-90 (a response rate of 79.6%).

A significantly greater proportion of women than men had heard of NHS Direct (P=0.04). Among those aware of the service, we found no sex based difference in use. Use of the service declined significantly with age (P=0.014). Among those aware of the service, however, older people were still less likely to use it (P=0.0021). We found no differences in this study when making comparisons with respect to social class or ethnic group.

We asked participants who had heard of NHS Direct but had never used it their reasons for never having done so. The most commonly cited reason was that the respondent had never needed to. Among those older than 50, however, it was that the respondent would rather see their general practitioner.

These findings indicate that among people attending general practice, sex and age are determining factors in the awareness and use of NHS Direct. The finding of an equivalent level of use among men and women aware of it implies that simply increasing awareness will increase the use of the service among men particularly. With regard to age related differences however, the relative underuse by older people remains even among those aware of NHS Direct. Our results indicate that in older people a significant barrier to the use of the service exists, aside from a lack of awareness, and that this barrier may be a preference for seeing their general practitioner.