Jill Lewis of the Wales Audit Office explains how NHS Direct Wales needs to market itself better
A health service hotline needs to improve its integration with the NHS in Wales, an official report recommends.
NHS Direct Wales is a 24-hour health advice service used via the telephone or the internet and designed to take pressure off frontline medical staff.
But the Wales Audit Office has said it needs to be more efficient, improve call handling and have better promotion of its services.
The assembly government said it would consider the report's findings.
The audit office said the £9m-a-year was a valuable service but added that several improvements should be made.
NHS Direct Wales costs £9m and in 2008/09 the service received more than 340,000 calls and 450,000 visits to its website in 2008/2009.
It is designed to take pressure off frontline NHS staff and many have used it during the swine-flu outbreak.
And it has helped a third of callers look after themselves without recourse to GPs or accident and emergency departments.
The Wales Audit Office report says costs are roughly comparable with England and it provides a valuable service.
But it also said NHS Direct Wales could improve promotion of its service to the public, especially to older people and those in rural areas.
Call handling times could be improved and staff absence through sickness and turnover levels cut back.
And it said the service could be more seamlessly integrated with the rest of the NHS.
The report recommends:
Information on cost and performance should be given at national and local level.
Patients' behaviour and choices should be monitored.
NHS Direct Wales should take action to support more appropriate forms of unscheduled care.
The assembly government and local health boards should investigate ways NHS Direct Wales could help manage chronic conditions.
Jonathan Morgan, AM, said lessons should be learned
The Auditor General for Wales, Jeremy Colman, said: "While NHS Direct provides valuable services which most people seem to like, there is scope for it to be much more effectively integrated within the unscheduled care system, providing a more seamless service for the public.
"I hope the wider NHS will take on my recommendations in order to realise the potential of NHS Direct to help make the unscheduled care service easier for the public to use."
Chair of the assembly audit committee, Jonathan Morgan AM, said NHS Direct Wales should be recognised as central to the health service.
But he said it was seen as something separate, rather than a core part of the unscheduled care system and its contribution was "poorly understood across the NHS".
Welsh Liberal Democrat health spokesman Peter Black AM, said the report's findings worried him.
"I have had concerns for some time at the way that NHS Direct Wales appears to operate independently of the rest of the health service and this report reinforces my views," he said.
An assembly government spokesperson said: "The Health Minister, Edwina Hart, has received a copy of the report and she will consider its findings and recommendations."
Carol Jones, the director of the Board of Community Health Councils in Wales who used to work at NHS Direct Wales, said more needs to be done to raise public awareness.
She said: "Clearly the majority of the public do not have an awareness about what the service offers.
"Marketing would help significantly. Very rarely do we hear from anyone within NHS Direct Wales about any issues to do with health, so that really is a bit of a guide as to how much awareness there is. I think a lot can be done to raise the profile."
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