Teleneurology by Telephone: NHS Direct

  • Andrew J. Larner


In the United Kingdom, the NHS Direct organization was established as part of the National Health Service (NHS) in 1998 (Department of Health 1998). The idea of a 24-h health and information telephone line was first suggested in a 1996 report on emergency services in the community by Sir Kenneth Calman, the then Chief Medical Officer. Initially launched in the spring of 1998 in selected areas of England, the NHS Direct service was gradually “rolled out” to the whole of the UK by the end of 2000. The aims of this government-sponsored service were to disseminate medical information and advice to support patient self-care and appropriate self-referral without recourse to a doctor.


National Health Service Chronic Daily Headache Male Call Chief Medical Officer Auditor General 
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  1. Abbott J, Alberti H. NHS Direct. Br J Gen Pract. 2001;51:580–1.PubMedGoogle Scholar
  2. Atherton D. Increasing referrals are direct result of phone advice. BMA News. 2002;7th December:9.Google Scholar
  3. Banks I. The NHS Direct healthcare guide. London: NHS Direct; 2000.Google Scholar
  4. Bessant M, King EA, Peveler R. Characteristics of suicides in recent contact with NHS Direct. Psychiatr Bull. 2008;32:92–5.CrossRefGoogle Scholar
  5. Bibi M, Attwell RW, Fairhurst RJ. The usage of NHS Direct by different ethnic and gender groups in an urban population. Rev Environ Health. 2008;23:235–41.PubMedCrossRefGoogle Scholar
  6. British Association for the Study of Headache. Review of the organisation of headache services in primary care and recommendations for change. London: British Association for the Study of Headache; 2000. p. 18 (section 3.3.10).Google Scholar
  7. Brown H. NHS Direct: love it or hate it? GM Geriatr Med. 2002;32(7):7.Google Scholar
  8. Burt J, Hooper R, Jessopp L. The relationship between use of NHS Direct and deprivation in southeast London: an ecological analysis. J Public Health Med. 2003;25:174–6.PubMedCrossRefGoogle Scholar
  9. Carson AJ, Ringbauer B, MacKenzie L, Warlow C, Sharpe M. Neurological disease, emotional disorder, and disability: they are related: a study of 300 consecutive new referrals to a neurology outpatient department. J Neurol Neurosurg Psychiatry. 2000;68:202–6.PubMedCrossRefGoogle Scholar
  10. Comptroller and Auditor General. NHS Direct in England. London: Stationary Office; 2002.Google Scholar
  11. Cooper D, Arnold E, Smith G, Hollyoak V, Chinemana F, Baker M, et al. The effect of deprivation, age and sex on NHS Direct call rates. Br J Gen Pract. 2005;55:287–91.PubMedGoogle Scholar
  12. David OJ. NHS Direct and older people. Age Ageing. 2005;34:499–501.PubMedCrossRefGoogle Scholar
  13. Department of Health. The new NHS. London: Department of Health; 1998.Google Scholar
  14. Donaldson L. Telephone access to health care: the role of NHS Direct. J R Coll Physicians Lond. 2000;34:33–5.PubMedGoogle Scholar
  15. Foster J, Jessopp L, Chakraborti S. Do callers to NHS Direct follow the advice to attend an accident and emergency department? Emerg Med J. 2003;20:285–8.PubMedCrossRefGoogle Scholar
  16. George S. NHS Direct audited. Customer satisfaction, but at what price? BMJ. 2002;324:558–9.PubMedCrossRefGoogle Scholar
  17. Grant C, Nicholas R, Moore L, Salisbury C. An observational study comparing quality of care in walk-in centres with general practice and NHS Direct using standardised patients. BMJ. 2002;324:1556–9.PubMedCrossRefGoogle Scholar
  18. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8 suppl 7:1–96.Google Scholar
  19. Knowles E, Munro J, O’Cathain A, Nicholl J. Equity of access to health care. Evidence from NHS Direct in the UK. J Telemed Telecare. 2006;12:262–5.PubMedCrossRefGoogle Scholar
  20. Larner AJ. Use of Internet medical websites and NHS Direct by neurology outpatients before consultation. Int J Clin Pract. 2002a;56:219–21.PubMedGoogle Scholar
  21. Larner AJ. NHS Direct: growing awareness and use. Clin Med (J R Coll Physicians Lond). 2002b;2:275–6.Google Scholar
  22. Larner AJ. NHS Direct for headache. J Neurol Neurosurg Psychiatry. 2003a;74:1698.PubMedCrossRefGoogle Scholar
  23. Larner AJ. Use of the internet and of the NHS Direct telephone helpline for medical information by a cognitive function clinic population. Int J Geriatr Psychiatry. 2003b;18:118–22.PubMedCrossRefGoogle Scholar
  24. Larner AJ. Teleneurology by telephone. In: Wootton R, Patterson V, editors. Teleneurology. London: Royal Society of Medicine Press; 2005. p. 9–16.Google Scholar
  25. Larner AJ. Late presentation of primary headache associated with sexual activity: Is non-invasive angiography worthwhile? J Headache Pain. 2006;7:139–40.PubMedCrossRefGoogle Scholar
  26. Larner AJ. Neurological signs: Behçet’s disease, coeliac disease, both, or neither? Eur J Neurol. 2007;14:e6.PubMedCrossRefGoogle Scholar
  27. Larner AJ. Trigeminal autonomic cephalalgias: frequency in a general neurology clinic setting. J Headache Pain. 2008;9:325–6.PubMedCrossRefGoogle Scholar
  28. Larner AJ. NHS Direct telephone helpline: frequency of use over time and by age and gender in an outpatient population. Telemed e-Health. 2009;15:199–201.CrossRefGoogle Scholar
  29. Larner AJ. Non-invasive angiography in late presenting primary headache associated with sexual activity: a 10-year study. Eur J Neurol. 2010;17 suppl 3:252 (abstract P1452).Google Scholar
  30. Larner AJ. Telemedicine and older people. GM Geriatr Med. 2011;41:247–250, 252.Google Scholar
  31. Loveridge P, Cooper D, Elliot AJ, Harris J, Gray J, Large S, et al. Vomiting calls to NHS Direct provide an early warning of norovirus outbreaks in hospitals. J Hosp Infect. 2010;74:385–93.PubMedCrossRefGoogle Scholar
  32. Moore R. A framework for telephone nursing. Nurs Times. 2001;97(16):36–7 (19 April).PubMedGoogle Scholar
  33. Munro J, Nicholl J, O’Cathain A, Knowles E. Impact of NHS Direct on demand for immediate care: observational study. BMJ. 2000;321:150–3.PubMedCrossRefGoogle Scholar
  34. Munro J, Sampson F, Nicholl J. The impact of NHS Direct on the demand for out-of-hours primary and emergency care. Br J Gen Pract. 2005;55:790–2.PubMedGoogle Scholar
  35. O’Cathain A, Munro JF, Nicholl JP, Knowles E. How helpful is NHS Direct? Postal survey of callers. BMJ. 2000;320:1035.PubMedCrossRefGoogle Scholar
  36. O’Cathain A, Webber E, Nicholl J, Munro J, Knowles E. NHS Direct: consistency of triage outcomes. Emerg Med J. 2003;20:289–92.PubMedCrossRefGoogle Scholar
  37. O’Cathain A, Goode J, Luff D, Strangleman T, Hanlon G, Greatbatch D. Does NHS Direct empower patients? Soc Sci Med. 2005;61:1761–71.PubMedCrossRefGoogle Scholar
  38. Ratcliff N. NHS Direct – help or hindrance. Which? 2003;July:10–3.Google Scholar
  39. Richards DA, Godfrey L, Tawfik J, Ryan M, Meakins J, Dutton E, et al. NHS Direct versus general practice based triage for same day appointments in primary care: cluster randomised controlled trial. BMJ. 2004;329:774–7.PubMedCrossRefGoogle Scholar
  40. Ring F, Jones M. NHS Direct usage in a GP population of children under 5 years: is NHS Direct used by people with the greatest health need? Br J Gen Pract. 2004;54:211–3.PubMedGoogle Scholar
  41. Sadler M. NHS Direct reducing its A&E referrals. BMA News. 2005;21st May:9.Google Scholar
  42. Sadler M, Vaughan M. NHS Direct is a learning organisation. BMJ. 2001;322:175.PubMedCrossRefGoogle Scholar
  43. Ullah W, Theivendra A, Sood V, Vasireddy A, Maryon-Davis A. Men and older people are less likely to use NHS Direct. BMJ. 2003;326:710.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Cognitive Function ClinicWalton Centre for Neurology and NeurosurgeryLiverpoolUK
  2. 2.Society of Apothecaries’ Honorary Lecturer in the History of MedicineUniversity of LiverpoolLiverpoolUK

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