Impact of NHS Direct on general practice consultations during the winter of 1999-2000: analysis of routinely collected data

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Abstract
We used general practices' telephone area codes to categorise those practices that participate in the Royal College of General Practitioners' weekly returns service on the basis of the degree of cover provided by NHS Direct during the winter of 1999-2000.5 The three groups were practices covered by NHS Direct since April 1999 (“full cover”), practices covered since November 1999 (“part cover”), and practices not covered until April 2000 or later (“no cover”). We compared weekly data on new episodes—as diagnosed by general practitioners—of influenza-like illness, acute bronchitis, and an aggregation of respiratory diseases with probable infectious aetiology during the winter of 1999-2000 with the three preceding winters. We also examined overall numbers of consultations per population. For each cover group and for each disease we calculated the mean weekly incidence per 100 000 population for week 48 to week 8, when respiratory illness is at its peak, and for the remaining winter weeks 35 to 47 and 9 to 20. As a comparative baseline we calculated equivalent data on incidence for the winters 1996-7, 1997-8, and 1998-9, when NHS Direct was not operating.