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NHS Direct is asking nurses to help assess its referral rate

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The nurse-led telephone triage service NHS Direct has started reviewing how it can improve its performance in order to boost the percentage of calls it resolve in-house without referral.

Department of Health targets for 2008-2009 are for over 50% of calls to be resolved within NHS Direct and less than 20% to be referred on for urgent GP appointments or to A&E. But, despite some evidence to the contrary, the nurse-run helpline has been long been dogged by claims of over-referral.

As a result, the most common types of calls to the helpline have been converted into case studies for testing at seven nurse workshops around the country. Nurses at each workshop will be asked to decide how they would deal with each case example and their decisions compared with those originally taken by the NHS Direct advisors.

Results from the 12-week review will be published in January. From this, NHS Direct will decide whether its clinical algorithms are appropriate – improving them and updating staff training where relevant.

‘Where it is appropriate we will emphasis self-care more and we want to engage more with other, newer services such as community and children’s nursing services,’ said Patricia Hamilton, deputy chief nurse at NHS Direct.

Helen Young, the telephone triage service’s clinical director, attended the first workshop last week in Bristol. She said: ‘The assumption is that we refer more people on but, interestingly, the clinicians round the table would have referred more on than we would have done.’

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