The NHS Direct service in Wales has been “bolted on” to the rest of the emergency system and could be improved if staff sickness levels and call lengths were reduced, the Audit Office has said.

While conceding that the telephone and internet system performed a valuable function at a reasonable cost, the report stated that efficiency could be improved by a closer integration of the scheme with the rest of the NHS.

It also found that while user satisfaction was generally high, many felt annoyed at the number of questions they had been asked.

Auditor General Jeremy Colman said: “While NHS Direct provides valuable services which most people seem to like, there is scope for it to be much more effectively integrated within the unscheduled care system, providing a more seamless service for the public.”

The scheme, which was launched in 2000, received more than 340,000 calls last year, costing around £26 per call. It also had 450,000 web visits.