Staff taking calls at NHS Direct, the Government's nurse-led medical helpline, pretended to be answering machines when the service could not cope with demand, it has been claimed.

NHS Direct was set up to provide patients with basic medical advice as an alternative to contacting their doctor.

Demand for the service has been high, and over the Christmas and New Year period the automated answering service covering Surrey, Sussex and parts of Kent failed to cope and broke down.

To ensure that patients did not simply hear an engaged tone, call handlers were asked to stand in and recite the recorded message.

The answering system is triggered when the service cannot cope with the number of people calling the 24-hour telephone advice line.

The medical magazines Hospital Doctor and Doctor report that instead of simply explaining the situation to patients, call handlers were told to read a set message.

Callers were asked to phone again later or leave a number on which they could be called back, or to contact their GP if their case was urgent.

Even when callers realised they were listening to a real person, and challenged them, the call handlers repeated the message as if they were an answerphone.

This was done to avoid callers getting into lengthy discussions with patients.

Official denial

The Department of Health issued a statement in which it denied staff pretended to be answering machines.

Instead, it said that staff "stuck to a script as they were not qualified to give advice".

The statement goes on to explain that in times of extreme pressure most NHS Direct sites use a messaging service saying that if a caller is worried they should stay on the line, if not call back later.

"In this instance a problem with the telephone line meant that only an engaged tone was heard at these times.

"Rather than leave callers hearing this, the NHS Direct site decided to use call handlers to deliver the same options."