Editor,—In his annotation “NHS Direct: here and now”,1 McLellan raises questions about the new service and highlights some of the criticisms levelled against it.2 We would like to offer some evidence in favour of NHS Direct.

Initial analysis of call volumes and caller awareness for NHS Direct in West Yorkshire reveals an interesting fact. Of the first 27 945 calls received (April to August 1999), 3945 (15%) had heard of NHS Direct from their local Accident and Emergency (A&E) department. Fatovichet al have shown that the average time to deal with a telephone call for medical advice to an A&E department is 3.9 minutes (range 0.25–25 minutes).3 To deal with 3945 such calls would take on average 15 385 minutes (256 hours). Over this five month period, this translates into a potential saving of more than six working weeks (assuming a working week of 40 hours) for A&E services across West Yorkshire. Even though this calculation ignores the time needed to tell a caller to ring NHS Direct, it still represents a substantial time saving.

We wonder what the saving will be nationally as the service grows?