Who uses NHS Direct? Investigating the impact of ethnicity on the uptake of telephone based healthcare

Abstract

IntroductionNHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to determine how the diverse population in England have engaged with this service.MethodsNHS Direct call data from the combined months of July, 2010 October, 2010, January 2011 and April, 2011 was analysed (N = 1,342, 245) for all 0845 4647 NHS Direct core service calls in England. Expected usage of NHS Direct was determined for each ethnic group of the population by age and gender and compared by actual usage using Chi-square analysis. A one-way analysis of variance (ANOVA) was used to determine variations of uptake by ethnic group and Index for Multiple Deprivation (IMD) 2010 rank.ResultsResults confirmed that all mixed ethnic groups (White and Black Caribbean, White and Black African, White and Asian) had a higher than expected uptake of NHS Direct which held consistent across all age groups. Lower than expected uptake was found for Black (African/Caribbean) and Asian (Bangladeshi/Indian/Chinese) ethnic group which held consistent by age and gender. For the Pakistani ethnic group usage was higher than expected in adults aged 40 years and older although was lower than expected in younger age groups (0–39).ConclusionFindings support previous research suggesting a variation in usage of NHS Direct influenced by ethnicity, which is evidenced on a national level. Further research is now required to examine the underlying barriers that contribute to the ethnic variation in uptake of this service.

A study of urgent and emergency referrals from NHS Direct within England

“…This was supported by prospective research which showed a reduction in urgent care referrals calls, with in excess of 40% of all calls without onward referral needed. 10 However, no evident effect was found on emergency services. 11…”

“…While NHS Direct has been able to support in excess of 40% of all calls without onward referral needed, 10 the number of symptomatic calls referred to urgent and emergency care (999, A&E and GP urgent) has not been widely published. Previous research has analysed symptom variation of NHS Direct patients for older 13 and young people (0–15 years old); 14 however, no research has explored referral to urgent and emergency healthcare services across the national population.…”

Registered nurses´ views on telephone nursing for patients with respiratory tract infections in primary healthcare – a qualitative interview study

“…Most research has examined the use of telephone nursing in an out-of-hours context [3,[11][12][13]. In recent years, some studies from UK report the effects of introducing telephone nursing in primary healthcare during office hours [14][15][16][17] but research concerning the RNs' experience of telephone work is sparse [18].…”

Registered Nurses´ Views on Telephone Nursing for Patients with Respiratory Tract Infections in Primary Health Care – A qualitative interview study

“…Most research has examined the use of telephone nursing in an out-of-hours context (3,(11)(12)(13). In recent years, some studies from UK report the effects of introducing telephone nursing in primary care during office hours (14-17) but research concerning the RNs' experience of telephone work is sparse (18).…”