ArticleBMJ (Clinical research ed.)2000
Impact of NHS direct on demand for immediate care: observational study.
Article in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
61 citing papers in PubMed, 6 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Pooled it
- Effectiveness of Acute Care Remote Triage Systems: a Systematic Review.Journal of general internal medicine · 2020Pooled it
- The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2005Pooled it
- Systematic review of recent innovations in service provision to improve access to primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Pooled it
- Walk-in centres in primary care: a review of the international literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003Pooled it
- The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Pooled it
- Randomised controlled trial of an intervention to improve parental knowledge and management practices of fever.BMC pediatrics · 2019Trial
- NHS Direct versus general practice based triage for same day appointments in primary care: cluster randomised controlled trial.BMJ (Clinical research ed.) · 2004Trial
- Spatial agglomeration in the use of emergency telephone consultation services in a prefecture of Japan: a geographic information system-based spatial statistical analysis.BMC health services research · 2026Article
- Article
- Evaluating Google Trends as a proxy for symptom incidence: insights from the winter COVID-19 infection study in England 2023/24.Epidemiology and infection · 2025Article
- From Fax to Secure File Transfer Protocol: The 25-Year Evolution of Real-Time Syndromic Surveillance in England.Journal of medical Internet research · 2024Article
- Observational
- "What's the evidence?"-Towards more empirical evaluations of the impact of OR interventions in healthcare.Health systems (Basingstoke, England) · 2022Article
- Emergency admission risk stratification tools in UK primary care: a cross-sectional survey of availability and use.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Article
- Age and Sex Differences in the Use of Emergency Telephone Consultation Services in Saitama, Japan: A Population-Based Observational Study.International journal of environmental research and public health · 2019Observational
- Contacting out-of-hours primary care or emergency medical services for time-critical conditions - impact on patient outcomes.BMC health services research · 2019Observational
- No such thing as bad publicity? A quantitative content analysis of print media representations of primary care out-of-hours services.BMJ open · 2019Article
- Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the impact of NHS Direct on the use of accident and emergency, ambulance, and general practitioner cooperative services.
designObservational study of trends in use of NHS Direct and other immediate care services over 24 months spanning introduction of NHS Direct.
settingThree areas in England in first wave of introduction of NHS Direct, and six nearby general practitioner cooperatives as controls. SUBJECTS: All contacts with these immediate care services.
main outcome measuresChanges in trends in use after introduction of NHS Direct.
resultsNHS Direct received about 68 500 calls from a population of 1.3 million in its first year of operation, of which 72% were out of hours and 22% about a child aged under 5 years. Changes in trends in use of accident and emergency departments and ambulance services after introduction of NHS Direct were small and non-significant. Changes in trends in use of general practitioner cooperatives were also small but significant, from an increase of 2.0% a month before introduction of NHS Direct to -0.8% afterwards (relative change -2. 9% (95% confidence interval -4.2% to -1.5%)). This reduction in trend was significant both for calls handled by telephone advice alone and for those resulting in direct contact with a doctor. In contrast, the six control cooperatives showed no evidence of change in trend; an increase of 0.8% a month before NHS Direct and 0.9% after (relative change 0.1% (-0.9% to 1.1%)).
conclusionIn its first year NHS Direct did not reduce the pressure on NHS immediate care services, although it may have restrained increasing demand on one important part-general practitioners' out of hours services.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.