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An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales

Helen Snooks, Julie Peconi, James Munro, Wai-Yee Cheung, Jaynie Rance Orcid Logo, Anne Williams

BMC Health Services Research, Volume: 9, Issue: 1, Start page: 178

Swansea University Author: Jaynie Rance Orcid Logo

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Abstract

<p>Background: An evaluation of NHS Direct Wales (NHSDW), a national telephone-based healthcare advice and information service, was undertaken. A key objective was to describe the actions of callers and assess the appropriateness of advice and healthcare contacts made following calls, results...

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Published in: BMC Health Services Research
ISSN: 1472-6963
Published: BioMed Central 2009
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spelling 2015-05-11T09:35:48.5529065 v2 6954 2012-01-30 An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales 14360f4993b452995fbc22db857cabf7 0000-0002-9504-0675 Jaynie Rance Jaynie Rance true false 2012-01-30 HPS <p>Background: An evaluation of NHS Direct Wales (NHSDW), a national telephone-based healthcare advice and information service, was undertaken. A key objective was to describe the actions of callers and assess the appropriateness of advice and healthcare contacts made following calls, results of which are reported here. Methods: Postal questionnaires were sent to consecutive callers to NHSDW in May 2002 and February 2004 to determine 1) callers' actions following calls and 2) their views about the appropriateness of: advice given; and when to seek further care. An independent clinical panel agreed and applied a set of rules about healthcare sites where examinations, investigations, treatments and referrals could be obtained. The rules were then applied to the subsequent contacts to healthcare services reported by respondents and actions were classified in terms of whether they had been necessary and sufficient for the care received. Results: Response rates were similar in each survey: 1033/1897 (54.5%); 606/1204 (50.3%), with 75% reporting contacting NHSDW. In both surveys, nearly half of all callers reported making no further healthcare contact after their call to NHSDW. The most frequent subsequent contacts made were with GPs. More than four fifths of callers rated the advice given - concerning any further care needed and when to seek it - as appropriate (further care needed: survey 1: 673/729, 82.3%; survey 2: 389/421, 92.4%; when to seek further care - survey 1: 462/555, 83.2%; survey 2: n = 295/346, 85.3%). A similar proportion of cases was also rated through the rule set and backed up by the clinical panel as having taken necessary and sufficient actions following their calls to NHSDW (survey 1: 624/729, 80.6%; survey 2: 362/421, 84.4%), with more unnecessary than insufficient actions identified at each survey (survey 1: unnecessary 132/729, 17.1% versus insufficient 11/729, 1.4%; survey 2: unnecessary 47/421, 11.0% versus insufficient 14/421, 3.3%). Conclusion: Based on NHSDW caller surveys responses and applying a transparent rule set to caller actions a large majority of subsequent actions were assessed as appropriate, with insufficient contacts particularly infrequent. The challenge for NHSDW is to reduce the number of unnecessary contacts made following calls to the service, whilst maintaining safety.</p> Journal Article BMC Health Services Research 9 1 178 BioMed Central 1472-6963 30 9 2009 2009-09-30 10.1186/1472-6963-9-178 http://www.biomedcentral.com/bmchealthservres/ COLLEGE NANME Psychology COLLEGE CODE HPS Swansea University 2015-05-11T09:35:48.5529065 2012-01-30T07:56:25.5800000 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Helen Snooks 1 Julie Peconi 2 James Munro 3 Wai-Yee Cheung 4 Jaynie Rance 0000-0002-9504-0675 5 Anne Williams 6
title An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
spellingShingle An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
Jaynie Rance
title_short An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
title_full An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
title_fullStr An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
title_full_unstemmed An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
title_sort An evaluation of the appropriateness of advice and healthcare contacts made following calls to NHS Direct Wales
author_id_str_mv 14360f4993b452995fbc22db857cabf7
author_id_fullname_str_mv 14360f4993b452995fbc22db857cabf7_***_Jaynie Rance
author Jaynie Rance
author2 Helen Snooks
Julie Peconi
James Munro
Wai-Yee Cheung
Jaynie Rance
Anne Williams
format Journal article
container_title BMC Health Services Research
container_volume 9
container_issue 1
container_start_page 178
publishDate 2009
institution Swansea University
issn 1472-6963
doi_str_mv 10.1186/1472-6963-9-178
publisher BioMed Central
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
url http://www.biomedcentral.com/bmchealthservres/
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description <p>Background: An evaluation of NHS Direct Wales (NHSDW), a national telephone-based healthcare advice and information service, was undertaken. A key objective was to describe the actions of callers and assess the appropriateness of advice and healthcare contacts made following calls, results of which are reported here. Methods: Postal questionnaires were sent to consecutive callers to NHSDW in May 2002 and February 2004 to determine 1) callers' actions following calls and 2) their views about the appropriateness of: advice given; and when to seek further care. An independent clinical panel agreed and applied a set of rules about healthcare sites where examinations, investigations, treatments and referrals could be obtained. The rules were then applied to the subsequent contacts to healthcare services reported by respondents and actions were classified in terms of whether they had been necessary and sufficient for the care received. Results: Response rates were similar in each survey: 1033/1897 (54.5%); 606/1204 (50.3%), with 75% reporting contacting NHSDW. In both surveys, nearly half of all callers reported making no further healthcare contact after their call to NHSDW. The most frequent subsequent contacts made were with GPs. More than four fifths of callers rated the advice given - concerning any further care needed and when to seek it - as appropriate (further care needed: survey 1: 673/729, 82.3%; survey 2: 389/421, 92.4%; when to seek further care - survey 1: 462/555, 83.2%; survey 2: n = 295/346, 85.3%). A similar proportion of cases was also rated through the rule set and backed up by the clinical panel as having taken necessary and sufficient actions following their calls to NHSDW (survey 1: 624/729, 80.6%; survey 2: 362/421, 84.4%), with more unnecessary than insufficient actions identified at each survey (survey 1: unnecessary 132/729, 17.1% versus insufficient 11/729, 1.4%; survey 2: unnecessary 47/421, 11.0% versus insufficient 14/421, 3.3%). Conclusion: Based on NHSDW caller surveys responses and applying a transparent rule set to caller actions a large majority of subsequent actions were assessed as appropriate, with insufficient contacts particularly infrequent. The challenge for NHSDW is to reduce the number of unnecessary contacts made following calls to the service, whilst maintaining safety.</p>
published_date 2009-09-30T03:08:35Z
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