WHITE PAPER Government could break up advice and info services

Published: 17/11/2005 Volume 115 No. 5982 Page 6

NHS Direct will make its case for survival this week as it faces the imminent regional break-up of its national contract to provide unscheduled and urgent care advice and information services.

The government is widely expected to advocate regional breakup of unscheduled access to advice and information in its forthcoming white paper on healthcare outside hospitals. This is partly fuelled by feedback from the recent public consultation at which the Department of Health found only patchy awareness of the service, HSJ understands.

NHS Direct was expected yesterday to outline its vision for a national non-urgent information service, which it wants to run.

Speaking to HSJ before its first major conference this week, the organisation's medical director, Dr Mike Sadler, said he fully accepted 'there will be some areas where services will be contestable' following the white paper.

He added that he believes unscheduled care should be locally commissioned. However, he argued that national contracts should be awarded for the provision of web, phone and digital information services.

The proposed contracts would also cover integrated health and social care advice and interactive forums for patients with long-term conditions.

'We have said in our consultation response that specific internet and digital television health information provision, which we are already doing in some areas, will only be cost effective if commissioned on a national basis, ' he said.

'For others to start from scratch what is a difficult and costly service to promote, to divide that market up when we have a service that generates 2 million contacts a month for only£2.40 per head of population, would be unhelpful both for the NHS and the DoH, ' he said.

Former DoH head of unscheduled care Pippa Bagnall told an NHS Confederation conference at the beginning of the month that she believed the government still believed in 'the model' of an unscheduled, nurse-led telephone health advice service, but 'perhaps not the way it is currently delivered'.

Ms Bagnall is currently leading on a regional pilot of an integrated urgent care service for Avon, Gloucestershire and Wiltshire strategic health authority.