The launch of NHS Direct in 1997 marked the start of a revolution in the way that the NHS communicates with its users. Yet a decade on, an ntl:Telewest Business survey has shown that people are still confused about when to call the nurse-led helpline, when to dial 999, and when to turn to their GP or out-of-hours service.

The national roll out of NHS Pathways, which enables control room staff to direct 999 callers to alternative local services, is another step towards dealing with patients more effectively. However, increased patient education and more creative uses of next generation network capabilities may be needed.

NHS organisations are starting to see the benefits of modern communications networks internally. IP handsets make it easier for healthcare professionals to find information, assets and each other, and IPVPNs open up new possibilities for communicating with staff working off-site. NHS Hounslow is just one primary care trust showing what can be done.

Police forces and local authorities, however, are setting up non-emergency numbers and other new services for the public. The local NHS should think about following their lead by using telecommunications technology to help patients reach the right service at the right time, safely and efficiently.