Evaluation of NHS Direct ‘‘referral’’ to community\ud pharmacists

Article English OPEN
Munro, J.F. ; O'Cathain, A. ; Knowles, E. ; Nicholl, J. (2003)
  • Subject:
    mesheuropmc: education | health care economics and organizations | health care facilities, manpower, and services

OBJECTIVES: To evaluate a pilot scheme of referrals from a nurse-led telephone helpline (NHS\ud Direct) to community pharmacists.\ud \ud \ud METHODS: A multi-method approach, including analysis of routine data from NHS Direct, postal\ud surveys of NHS Direct callers, analysis of anonymised transcripts of calls, a postal survey of callers\ud referred to pharmacists, and face-to-face interviews with NHS Direct nurses.\ud \ud SETTING: Essex, Barking and Havering.\ud \ud KEY FINDINGS: During the first three months of the pilot scheme, 6% (1,995/31,674) of NHS Direct\ud calls triaged by nurses were logged as referred to pharmacists. This built on an existing foundation of\ud informal referral to pharmacists of 4%. There was no measurable change in callers’ views of the\ud helpfulness of advice, enablement, or caller satisfaction associated with the scheme. Conditions sent\ud to pharmacists included skin rash, cough, sore throat, stomach pain, and vomiting and/or diarrhoea.\ud 86% (54/63) of callers referred to pharmacists during the scheme felt the referral was very or quite\ud appropriate and 75% (48/64) attempted to contact a pharmacist. In general, those who did so found\ud the experience a positive one: 65% (31/48) spoke to the pharmacist, and 80% (28/35) of people\ud expressing an opinion were satisfied with the advice offered, but the lack of privacy in the pharmacy\ud was of some concern. Although routine data indicated high usage of the scheme, nurse referral of\ud callers to pharmacists declined over time. Their initial enthusiasm diminished due to concerns about\ud the appropriateness of guidelines, their lack of understanding of the rationale behind some referrals,\ud and the lack of feedback about the appropriateness of their referrals.\ud \ud CONCLUSIONS: The evaluation of the pilot scheme has generated a range of recommendations for\ud the wider national roll-out of the scheme, including revision of the guidelines and review of NHS\ud Direct nurse training for referral to pharmacy. NHS Direct and pharmacists should consider how to\ud strengthen the system of pharmacist feedback to NHS Direct.
  • References (17)
    17 references, page 1 of 2

    1 Department of Health. The New NHS: modern, dependable. Cmd 3807. London: Stationery Office; 1997.

    2 Scottish Executive. It's NHS 24 - Deacon announces details of new 'all day, every day' NHS phone service. Press release SE3208/2000. Edinburgh: Scottish Executive, December 13, 2000.

    3 Munro J, Nicholl JP, O'Cathain A, Knowles E. Evaluation of NHS Direct first wave sites: first interim report to the Department of Health. Sheffield: Medical Care Research Unit; 1998.

    4 Munro J, Nicholl JP, O'Cathain A, Knowles E. Evaluation of NHS Direct first wave sites: second interim report to the Department of Health. Sheffield: Medical Care Research Unit; 2000.

    5 Munro J, Nicholl JP, O'Cathain A, Knowles E, Morgan A. Evaluation of NHS Direct first wave sites: final report of the phase 1 research. Sheffield: Medical Care Research Unit; 2001.

    6 O'Cathain A, Munro JF, Knowles E, Nicholl JP. How helpful is NHS Direct? Postal survey of callers. BMJ 2000;320:1035.

    7Boseley S. Just hanging on the telephone. The Guardian, 2001 January 9.

    8 Munro JF, Nicholl JP, O'Cathain A, Knowles E. Impact of NHS Direct on demand for immediate care: observational study. BMJ 2000;321:150-3.

    9 Hassell K, Noyce PR, Rogers A, Harris J, Wilkinson J. A pathway to the GP: the pharmaceutical 'consultation' as a first port of call in primary health care. Fam Pract 1997;14:498-502. Cunningham-Burley S, Maclean U. Pharmacists and primary care: some research findings and recommendations. Fam Pract 1988;5:122-5. Tully MP, Hassell K, Noyce PR. Advice-giving in community pharmacies in the UK. J Health Serv Res Pol 1997;2:38-50. Hassell K, Whittington Z, Cantrill J, Bates F, Rogers A, Noyce P. Managing demand: transfer of management of self limiting conditions from general practice to community pharmacies. BMJ 2001;323:146-7. Department of Medicines Management. Development of Fourth Disposition in NHS Direct Essex Pilot: an academic review of guidelines. Keele University, September 1999.

    14. Howie JGR, Heaney DJ, Maxwell M, Walker JJ, Freeman GK, Rai H. Quality at general practice consultations: cross sectional survey. BMJ 1999;319:738-43.

  • Metrics
    views in OpenAIRE
    views in local repository
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    White Rose Research Online - IRUS-UK 0 49
Share - Bookmark