A new troubleshooting team will rally support for government plans to make NHS Direct the single point of access for all out-ofhours services.

Since its launch in 1998, GPs and the British Medical Association have expressed concern that NHS Direct might be unable to cope with the demand it generates.

A series of headline-grabbing incidents in which people with lifethreatening conditions were not referred appropriately have added to GP hostility to the helpline.

Last week saw the launch of a new partnership between NHS Direct and the National Association of GP Co-operatives (NAGPC), which represents GPrun out-of-hours services.

There are 15 sites across England where NHS Direct fields GP co-op calls.As a first step to all calls being dealt with in this way, the government wants to see NHS Direct taking 20 million calls - including GP out of hours calls - by 2004.

To meet this target, a troubleshooting team has been set up to tackle problems in existing services and convert GPs opposed to the plan. The team would comprise GPs and officials from NHS Direct and the NAGPC.

NHS Direct national project manager Dr Paul Jenkins said: 'If there are concerns in any part of the country, we can put together a joint team who will go in to make sure that everything is OK.'

Dr Mark Reynolds, chair of the NAGPC, said trouble-shooters would visit areas where there was hostility to NHS Direct to demonstrate the success of partnerships where the service handles calls for GP out-of-hours co-operatives.

'There are some people who still feel excluded from NHS Direct.

We will be telling them about the benefits in terms of hard facts about the way it frees up GPs to do the work they do best.'

In a bid to gain maximum coverage, Dr Jenkins said NHS Direct was already in talks with the private deputising service Healthcall.

'The vision of the government review for patients is that even if doctors use commercial deputising services they will be provided with a phone service to the same standards as provided by a GP co-operative.'

Dr Jenkins said that if the deal was successful, NHS Direct would provide nurse-led call handling and information and advice services while Healthcall would be responsible for GP cover, specialist advice and home visits.

Dr Jenkins revealed that an extra 800 nurses would be required to meet the 2004 target. 'NHS Direct has 1,200 whole-time equivalent nurses at the moment. To meet the kind of volume that we are planning by 2004 we will need 2000 whole-time equivalents.'