Sorry Mike I don't think NHSD bashing is fun. I wonder if any one has
audited the amount of callers who are sent an ambulance by NHSD and are
actually conveyed to hospital.
----- Original Message -----
From: "LAMBERT MIKE (RM1) Norfolk and Norwich NHS Trust"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, February 23, 2001 4:44 PM
Subject: Re: NHS Direct
> -----Original Message-----
> From: Stuart Pinborough [SMTP:[log in to unmask]]
> Sent: 23 February 2001 15:23
> To: [log in to unmask]
> Subject: NHS Direct
>
> I was under the impression that NHSD send an Ambulance for most of their
> callers, it saves them having to make a decision.
>
>
> I realise NHS Direct bashing is fun, but in view of this and other recent
> contributions about NHS Direct I thought a few facts and comments might be
> appropriate
>
> I represent BAEM on the NHS Direct National Clinical Reference Group, and
> before anyone asks - no I wasn't one of the A+ merit award holders (I
wish!)
> that Danny blames for the whole idea.
>
> At a recent meeting of the CRG the following, among other things, were
> discussed...
>
> * Data was presented to show how the new NHS Direct (NHSD) software
> (AXA) is performing. Currently the national average is 9% of all calls
> referred to A & E. This compares to 45% referred to primary care. My
> recollection is that 40% are refereed to self care and only 2-3% to "999".
> The reminder are referred to other agencies like pharmacy, health visitor
> etc.The average length of each call is currently 11 minutes.
> * Where NHSD sites have recently gone live or have had to change
from
> other IT systems to the new AXA system it was reported that the algorithms
> tend to sort "high" i.e. more likely to refer to A & E than GP, and that
> calls take longer. It is anticipated that as staff become more familiar
> with the newer algorithms that dispositions will become less acute.
> * NHSD relies very heavily on feedback to identify appropriate and
> inappropriate dispositions and referrals. It is essential that all A & E
> Departments familiarise themselves with local arrangements to feedback
> concerns about the working of NHSD. Currently this is done through a
"blue
> form" system. Forms should be available in every A&E Department.
>
> Also, BAEM has been asked to work with NHSD to review and develop all the
> algorithms currently in use. The Exec will discuss all these issues in
> March.
>
> If anyone has specific factual concerns about how NHSD is working in
> relation to their department or service I suggest you raise the issue -
> using the blue feedback forms - with the Medical Director for your local
> NHSD site or via your local clinical steering group (if you can't identify
> these people let me know and I will find out for you). Concerns will be
> investigated, usually including review of the algorithm and a recording of
> the call. If you find you are not getting a satisfactory response please
let
> me know and I will take it up with the national development team. The
> algorithms and the skills of the call takers and nurse advisors can only
> improve if we contribute appropriate feedback.
>
> The national development team will work with the CRG to define performance
> indicators and datasets which will improve analysis and understanding of
the
> contribution NHSD is making to the NHS as a whole. Any suggestions about
> information and regular reports you, as a specialty or an individual
> department, would like to receive about NHSD performance and activities
> would be welcome.
>
> NHS Direct - and developments such as the Clinical Advisory and Management
> System - will be an integral part of future health care provision. BAEM
has
> recognised that while NHSD has it's critics and is not perfect, it has the
> potential to make a significant contribution to the future delivery of
> emergency, and other, health care. The Association is working to make the
> relationship between BAEM, A&E departments and NHS Direct as constructive
> and positive as possible.
>
> Surely it is better to be actively involved and work with NHSD to help the
> system improve, than to use anecdote and ill-informed comment to criticise
> and so risk being side-lined in future emergency health care developments.
>
> Apologies for the long post, but I had to get that off my chest. I will
now
> sit back and await the abuse and brickbats!
>
> Mike Lambert
> Norwich.
>
>
>
>
>
>
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