Patients in Oxfordshire use NHS Direct less than people in surrounding counties because GPs are failing to promote it, according to the scheme's managers.

But one family doctor has claimed GPs have been warned off using the healthcare helpline, because staff have told them the service would not be able to cope with the increase in calls.

NHS Direct is manned by a team of trained nurses, who can offer guidance to callers.

Figures show that the Thames Valley and Northamptonshire service -- including Oxfordshire, Berkshire and Buckinghamshire -- has seen an increase in users.

In April 2003, there were 21, 431 calls -- an increase of 15 per cent since April 2002, when there were 18,585.

But Oxfordshire had the smallest share of users in both years.

In April 2003, only a fifth of calls came from the county. This year the figure rose to 21 per cent.

Barry Evans, of NHS Direct, said: "The reason that it doesn't seem to have taken off in Oxfordshire is primarily because GPs don't use it on their out-of-hours answer machines.

"In Northamptonshire, which provides the highest amount of callers, the majority of GP practices put the number on their answer machines."

But Bicester GP Dr John Galuszka, of Victoria House Surgery, said he and his colleagues had been told not to use the service.

Suggestion

He said: "There was a suggestion, at one time, that we would change our out-of-hours answer-phone message to include the NHS Direct number, but we were told not to by the service.

"They said they had not got enough capacity for the volume of calls it would receive if we promoted it."

Dr Galuszka claimed that although some doctors welcomed the service, many believed it was ineffective.

He said: "A lot of GPs are less happy with it and part of the reason is because a lot of the time it doesn't advise people, but just passes them on to other health prof- essionals."

Mr Evans denied that NHS Direct had told GPs not to use the service.

He said: "The message has always been that doctors should put our number on their answer machines. We would be more than happy for our message to be reiterated to GPs and I think, in the light of it, we may well do this."

NHS Direct offers immediate and confidential health advice and information 24 hours a day. Call 0845 4647 or visit www.nhsdirect.nhs.uk