Skip to main content
Top
Published in: International Journal for Equity in Health 1/2014

Open Access 01-12-2014 | Research

Who uses NHS Direct? Investigating the impact of ethnicity on the uptake of telephone based healthcare

Authors: Erica J Cook, Gurch Randhawa, Shirley Large, Andy Guppy, Angel M Chater, Dong Pang

Published in: International Journal for Equity in Health | Issue 1/2014

Login to get access

Abstract

Introduction

NHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to determine how the diverse population in England have engaged with this service.

Methods

NHS Direct call data from the combined months of July, 2010 October, 2010, January 2011 and April, 2011 was analysed (N = 1,342, 245) for all 0845 4647 NHS Direct core service calls in England. Expected usage of NHS Direct was determined for each ethnic group of the population by age and gender and compared by actual usage using Chi-square analysis. A one-way analysis of variance (ANOVA) was used to determine variations of uptake by ethnic group and Index for Multiple Deprivation (IMD) 2010 rank.

Results

Results confirmed that all mixed ethnic groups (White and Black Caribbean, White and Black African, White and Asian) had a higher than expected uptake of NHS Direct which held consistent across all age groups. Lower than expected uptake was found for Black (African/Caribbean) and Asian (Bangladeshi/Indian/Chinese) ethnic group which held consistent by age and gender. For the Pakistani ethnic group usage was higher than expected in adults aged 40 years and older although was lower than expected in younger age groups (0-39).

Conclusion

Findings support previous research suggesting a variation in usage of NHS Direct influenced by ethnicity, which is evidenced on a national level. Further research is now required to examine the underlying barriers that contribute to the ethnic variation in uptake of this service.
Appendix
Available only for authorised users
Literature
1.
go back to reference Department of Health: A modern and Dependable NHS. 1997, HMSO, London Department of Health: A modern and Dependable NHS. 1997, HMSO, London
4.
5.
go back to reference College of Nurses of Ontario: Practice Guideline: Telepractice. 2009, Standards of Care, Ontorio College of Nurses of Ontario: Practice Guideline: Telepractice. 2009, Standards of Care, Ontorio
6.
go back to reference Stacey D, Noorani HZ, Fisher A, Robinson D, Joyce J, Pong RW: Telephone Triage Services: Systematic Review and a Survey of Canadian Call Centre Programs. 2003, Canadian Coordinating Office for Health Technology Assessment, Ottawa Stacey D, Noorani HZ, Fisher A, Robinson D, Joyce J, Pong RW: Telephone Triage Services: Systematic Review and a Survey of Canadian Call Centre Programs. 2003, Canadian Coordinating Office for Health Technology Assessment, Ottawa
7.
8.
go back to reference Goodwin S: Telephone nursing: an emerging practice area. Nurs Leadersh. 2007, 20: 37-45. 10.12927/cjnl.2007.19470.CrossRef Goodwin S: Telephone nursing: an emerging practice area. Nurs Leadersh. 2007, 20: 37-45. 10.12927/cjnl.2007.19470.CrossRef
9.
go back to reference Department of Health: A Plan for Investment- A Plan for Reform. 2000, HMSO, London Department of Health: A Plan for Investment- A Plan for Reform. 2000, HMSO, London
10.
go back to reference Shah SM, Cook DG: Socio-economic determinants of casualty and NHS Direct use. J Publ Health. 2008, 30: 75-81. 10.1093/pubmed/fdn001.CrossRef Shah SM, Cook DG: Socio-economic determinants of casualty and NHS Direct use. J Publ Health. 2008, 30: 75-81. 10.1093/pubmed/fdn001.CrossRef
11.
go back to reference Bibi M, Attwell RW, Fairhurst RJ, Powell SC: The usage of NHS Direct by different ethnic and gender groups in an urban population. J Chronic Dis. 2008, 23: 235-241. Bibi M, Attwell RW, Fairhurst RJ, Powell SC: The usage of NHS Direct by different ethnic and gender groups in an urban population. J Chronic Dis. 2008, 23: 235-241.
12.
go back to reference Cook E: Who uses NHS Direct? Factors that impact on telephone based healthcare. In: University of Bedfordshire, Institute for Health Research; 2013. Cook E: Who uses NHS Direct? Factors that impact on telephone based healthcare. In: University of Bedfordshire, Institute for Health Research; 2013.
13.
go back to reference Cooper D, Chinemana F: NHS Direct derived data: an exciting new opportunity or an epidemiological headache?. J Publ Health. 2004, 26: 158-160. 10.1093/pubmed/fdh133.CrossRef Cooper D, Chinemana F: NHS Direct derived data: an exciting new opportunity or an epidemiological headache?. J Publ Health. 2004, 26: 158-160. 10.1093/pubmed/fdh133.CrossRef
14.
go back to reference Byrne G, Morgan J, Kendall S, Saberi D: A survey of NHS Direct callers’ use of health services and the interventions they received. Prim Health Care Res Dev. 2007, 8: 91-100. 10.1017/S1463423607000102.CrossRef Byrne G, Morgan J, Kendall S, Saberi D: A survey of NHS Direct callers’ use of health services and the interventions they received. Prim Health Care Res Dev. 2007, 8: 91-100. 10.1017/S1463423607000102.CrossRef
15.
go back to reference Ring F, Jones M: NHS Direct usage in a GP population of children under 5years: is NHS Direct used by people with the greatest health need?. Br J Gen Pract. 2004, 54: 211-213.PubMedCentralPubMed Ring F, Jones M: NHS Direct usage in a GP population of children under 5years: is NHS Direct used by people with the greatest health need?. Br J Gen Pract. 2004, 54: 211-213.PubMedCentralPubMed
16.
go back to reference Goode J, Hanlon G, Luff D, O'Cathain A, Strangleman T, Greatbatch D: Male callers to NHS Direct: the assertive carer, the new dad and the reluctant patient. Health. 2004, 8: 311-328.PubMed Goode J, Hanlon G, Luff D, O'Cathain A, Strangleman T, Greatbatch D: Male callers to NHS Direct: the assertive carer, the new dad and the reluctant patient. Health. 2004, 8: 311-328.PubMed
17.
18.
go back to reference Hanlon G: NHS Direct: Patient Empowerment or Dependency?. 2004, Economic and Social Research Council, Swindon Hanlon G: NHS Direct: Patient Empowerment or Dependency?. 2004, Economic and Social Research Council, Swindon
20.
go back to reference ONS: Population Estimates Analysis mid 2007. In: London: Office for National Statistics; 2009. ONS: Population Estimates Analysis mid 2007. In: London: Office for National Statistics; 2009.
21.
go back to reference ONS: Table EE4, Population Estimates by Ethnic Group. In: London: Office for National Statistics; 2011. ONS: Table EE4, Population Estimates by Ethnic Group. In: London: Office for National Statistics; 2011.
22.
go back to reference Department for Communities and Local Government: The English Indices of Deprivation 2010. 2011, Department for Communities and Local Government, London Department for Communities and Local Government: The English Indices of Deprivation 2010. 2011, Department for Communities and Local Government, London
23.
go back to reference IBM: IBM SPSS Statistics for Windows, Version 21.0. In: New York: IBM; 2012. IBM: IBM SPSS Statistics for Windows, Version 21.0. In: New York: IBM; 2012.
24.
go back to reference Cook E, Randhawa G, Large S, Guppy A, Chater A: A UK case study of who uses NHS Direct? Investigating the impact of age, gender and deprivation on the utilisation of NHS Direct. Telemed J E Health. 2012, 18: 693-698. 10.1089/tmj.2011.0256.PubMedCrossRef Cook E, Randhawa G, Large S, Guppy A, Chater A: A UK case study of who uses NHS Direct? Investigating the impact of age, gender and deprivation on the utilisation of NHS Direct. Telemed J E Health. 2012, 18: 693-698. 10.1089/tmj.2011.0256.PubMedCrossRef
25.
go back to reference Cook E, Randhawa G, Large S, Guppy A, Chater A: Who uses telephone based helplines? Relating deprivation indices to users of NHS Direct. Health Policy Technol. 2013, 2: 69-74. 10.1016/j.hlpt.2013.03.002.CrossRef Cook E, Randhawa G, Large S, Guppy A, Chater A: Who uses telephone based helplines? Relating deprivation indices to users of NHS Direct. Health Policy Technol. 2013, 2: 69-74. 10.1016/j.hlpt.2013.03.002.CrossRef
26.
go back to reference Hsu W, Bath PA, Large S, Williams S: Older people’s use of NHS Direct. Age Ageing. 2011, 40: 335-340. 10.1093/ageing/afr018.PubMedCrossRef Hsu W, Bath PA, Large S, Williams S: Older people’s use of NHS Direct. Age Ageing. 2011, 40: 335-340. 10.1093/ageing/afr018.PubMedCrossRef
27.
go back to reference Hunt SM, Bhopal B: Self report in clinical and epidemiological studies with non-English speakers: the challenge of language and culture. J Epidemiol Community Health. 2004, 58: 618-622. 10.1136/jech.2003.010074.PubMedCentralPubMedCrossRef Hunt SM, Bhopal B: Self report in clinical and epidemiological studies with non-English speakers: the challenge of language and culture. J Epidemiol Community Health. 2004, 58: 618-622. 10.1136/jech.2003.010074.PubMedCentralPubMedCrossRef
28.
go back to reference Acheson D: Independent Inquiry into Inequalities in Health. 1998, HMSO, London Acheson D: Independent Inquiry into Inequalities in Health. 1998, HMSO, London
29.
go back to reference Mackenbach J, Meerding WJ, Kunst A: Economic Implications of Socio-Economic Inequalities in Health in the European Union. 2007, European Communities, Luxemborg Mackenbach J, Meerding WJ, Kunst A: Economic Implications of Socio-Economic Inequalities in Health in the European Union. 2007, European Communities, Luxemborg
30.
31.
go back to reference Campbell SM, Rowland MO: Why do people consult the doctor?. Fam Pract. 1998, 13: 75-83. 10.1093/fampra/13.1.75.CrossRef Campbell SM, Rowland MO: Why do people consult the doctor?. Fam Pract. 1998, 13: 75-83. 10.1093/fampra/13.1.75.CrossRef
32.
go back to reference Netuveli G, Huwitz B, Levy M, Fletcher M, Barnes G, Durham SR, Sheikh A: Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis. Lancet. 2005, 365: 312-317. 10.1016/S0140-6736(05)17785-X.PubMedCrossRef Netuveli G, Huwitz B, Levy M, Fletcher M, Barnes G, Durham SR, Sheikh A: Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis. Lancet. 2005, 365: 312-317. 10.1016/S0140-6736(05)17785-X.PubMedCrossRef
33.
go back to reference Langkamp DL, Lehman A, Lemeshow S: Techniques for handling missing data in secondary analyses of large surveys. Acad Pediatr. 2010, 10: 205-210. 10.1016/j.acap.2010.01.005.PubMedCentralPubMedCrossRef Langkamp DL, Lehman A, Lemeshow S: Techniques for handling missing data in secondary analyses of large surveys. Acad Pediatr. 2010, 10: 205-210. 10.1016/j.acap.2010.01.005.PubMedCentralPubMedCrossRef
Metadata
Title
Who uses NHS Direct? Investigating the impact of ethnicity on the uptake of telephone based healthcare
Authors
Erica J Cook
Gurch Randhawa
Shirley Large
Andy Guppy
Angel M Chater
Dong Pang
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-014-0099-x

Other articles of this Issue 1/2014

International Journal for Equity in Health 1/2014 Go to the issue