The brief

NHS Direct offers health advice to the public, traditionally over the telephone. From early 2008, Digital Public started working with NHS Direct to develop and implement a digital strategy to:

• Enhance and increase the reach of NHS Direct’s online public services
• Enable more users to self-care where it is safe to do so, and so reduce inappropriate use of other NHS services, such as A&E and GP surgeries
• Improve users’ experience of NHS Direct services by offering new engagement channels (such as webchat), joining up online and offline channels and reducing the need to provide the same information more than once.

Our approach

A key vehicle for these changes was the development of online Self Assessment Tools (SATs) – interactive questionnaires that enable users to assess their symptoms and elicit clinically proven advice on how best to treat them – either through self care or through NHS services.

NHS Direct launched the first two of what will be an integrated suite of tools, on the topics of Colds & Flu and Contraceptive Advice in late 2008, both of which were seasonally relevant. Both SATs were recording over 4000 unique visits per week, and all users are asked whether they intend to follow the advice, and invited to leave further feedback; an exceptional 86% of Colds and Flu tool users state that they do intend to follow the advice.  All feedback gathered is used for continuous improvement of the online symptom checkers.

Following the emergence of Swine Flu in late April, Digital Public further facilitated the NHS Direct project team to deliver an enhanced colds & flu SAT that contained relevant content for handling Swine Flu issues and concerns. During this time use of the online tool rose twentyfold to nearly 100,000 per week – many of these users would otherwise have called the contact centre or visited other health providers, which would have increased pressure on GPs, A&E and other NHS public contact points, but using the online tool they were able to triage their symptoms and gain advice directly.

The programme continues in 2009 with the creation of the full suite of topics, numbering close to 40 in total.

Results

• Increased efficiency of contact centre operations by moving triage online and so reducing avoidable contact
• Transformed organisation to meet the demands of its own digital revolution.