Abstract
Methods: A representative three week period in May 2000 was investigated. During this period there were no health scares, major health campaigns, or bank holidays that may have affected the call rate. NHS Direct callers who were advised to attend A&E were identified. Data from the four A&E departments for the same three week period and two additional days were searched and matched to NHS Direct data by surname, date of birth, and post code. This process created three groups: (1) callers triaged to A&E who attended, (2) callers triaged to A&E who did not attend, (3) callers with different triage outcome who attended A&E. The age, sex, relationship of caller, time of call, and distance to nearest A&E were compared for groups (1) and (2).
Results: Just less than two third of callers triaged to A&E attended with the same presenting complaint. There were no statistically significant differences between group (1) and (2) in terms of age, sex, relationship of caller, time of call, and distance to A&E. A small number of callers (2.4%) were identified as being given other advice and attending A&E for the same presenting complaint. This group took significantly longer to attend A&E than group (1) (χ2 =139.01, df=7, p<0.001).
Conclusions: Assessing levels of compliance is difficult. These findings suggest that NHS Direct may have comparatively high levels of compliance compared with other similar services. However, using the single triage outcome as the means of identifying the advice given may oversimplify the range of possible advice given. The delay in attending A&E for the group of callers who were given other advice may indicate they had tried other actions. Further larger studies are needed to assess the appropriateness of referrals through investigation of clinical outcomes.
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Selected References
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- Baker R. C., Schubert C. J., Kirwan K. A., Lenkauskas S. M., Spaeth J. T. After-hours telephone triage and advice in private and nonprivate pediatric populations. Arch Pediatr Adolesc Med. 1999 Mar;153(3):292–296. doi: 10.1001/archpedi.153.3.292. [DOI] [PubMed] [Google Scholar]
- Dale J., Crouch R., Patel A., Williams S. Patients telephoning A&E for advice: a comparison of expectations and outcomes. J Accid Emerg Med. 1997 Jan;14(1):21–23. doi: 10.1136/emj.14.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Egleston C. V., Kelly H. C., Cope A. R. Use of a telephone advice line in an accident and emergency department. BMJ. 1994 Jan 1;308(6920):31–31. doi: 10.1136/bmj.308.6920.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gaffney P., Crane S., Johnson G., Playforth M. An analysis of calls referred to the emergency 999 service by NHS Direct. Emerg Med J. 2001 Jul;18(4):302–304. doi: 10.1136/emj.18.4.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones J., Playforth M. J. The effect of the introduction of NHS Direct on requests for telephone advice from an accident and emergency department. Emerg Med J. 2001 Jul;18(4):300–301. doi: 10.1136/emj.18.4.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kernohan S. M., Moir P. A., Beattie T. F. Telephone calls to a paediatric accident and emergency department. Health Bull (Edinb) 1992 May;50(3):233–236. [PubMed] [Google Scholar]
- Molyneux E., Jones N., Aldom G., Molyneux B. Audit of telephone advice in a paediatric accident and emergency department. J Accid Emerg Med. 1994 Dec;11(4):246–249. doi: 10.1136/emj.11.4.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Munro J., Nicholl J., O'Cathain A., Knowles E. Impact of NHS direct on demand for immediate care: observational study. BMJ. 2000 Jul 15;321(7254):150–153. doi: 10.1136/bmj.321.7254.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Payne F., Jessopp L. NHS Direct: review of activity data for the first year of operation at one site. J Public Health Med. 2001 Jun;23(2):155–158. doi: 10.1093/pubmed/23.2.155. [DOI] [PubMed] [Google Scholar]
- Pettinari C. J., Jessopp L. "Your ears become your eyes": managing the absence of visibility in NHS Direct. J Adv Nurs. 2001 Dec;36(5):668–675. doi: 10.1046/j.1365-2648.2001.02031.x. [DOI] [PubMed] [Google Scholar]