Operational Research for informed innovation: NHS Direct as a case study in the design, implementation and evaluation of a new public service

Delivering modern and responsive public services requires informed innovation drawing on a combination of design, planning and evaluative skills. The development of the national 24-hour telephone helpline service NHS Direct provides a case study demonstrating how, through using these skills, OR has been instrumental in achieving public service innovation. Firstly, OR analysts led strategic design and scenario-planning work, assessing the evidence on the performance of ‘direct’ services here and around the world and developing scenarios of an NHS where much greater use was made of modern communication technology, such as telephone call centres, to provide services. Secondly, we did modelling work to help determine the size, distribution and staffing of the call centres required in England to meet the likely demand and satisfy service performance targets. Thirdly, we set out evaluation criteria and developed performance-monitoring systems. NHS Direct has been one of the best-received innovations in the history of the NHS and Operational Research has made a crucial contribution to its development.