Cost analysis of nurse telephone consultation in out of hours primary care: evidence from a randomised controlled trial
The costs of telephone lines operated by nurses for out of hours primary care may save the NHS money in the long term, indicates research from the University of Southampton in this week's BMJ.
Lattimer and colleagues conducted a cost analysis of out of hours nurse telephone consultations for a general practice cooperative in Wiltshire, England for 12 months from January 1997. The cooperative includes 55 general practices serving 97,000 registered patients.
The costs of providing the telephone consultations amounted to just over £81,000 for the year, but over £94,000 was saved from reducing the demand for emergency admissions to hospital for both adults and children. If this figure were achieved across England, say the authors, it would be comparable with the estimated costs of providing NHS Direct sites at a cost of £1 per head of the population per year. Additional savings of almost £17,000 were made as a result of a reduced need for GPs to visit patients in their homes and fewer surgery appointments within three days of making a call. But, say the authors, GPs currently bear most of the cost of nurse telephone consultations and stand to gain least from the savings associated with it. The authors warn that the results may not apply where there is more than one access point to out of hours primary care services.
Dr Val Lattimer, Health Care Research Unit, University of Southampton