Letter: NHS changes

Sir: Your letters on the expansion of the nurse-led telephone consultation line, NHS Direct (30 April), raise important issues. NHS Direct should be seen as a complementary service to traditional general practice, not a replacement or threat to the continuity of the relationship between GP and patient.

As nurses we recognise that a fundamental principle of good primary care is accessibility. There's nothing wrong with a populist approach if the result is a system which provides the right care, at the right time and in the right place.

Research by the University of Southampton shows nurse telephone consultation is both safe and effective - moreover, patients like it.

By the end of next year, NHS Direct will be available nationally. For many, nurses will become a gateway to the health service, giving 24-hour healthcare advice or directing patients to their GP or accident and emergency department.

Nurses welcome this development in primary care which underlines, once again, the necessity of a highly-skilled and motivated nursing workforce, which is valued and properly rewarded.

CHRISTINE HANCOCK

General Secretary

Royal College of Nursing

London W1