In a report published on 15 September 2009 the audit office says the 24 hour phone and internet health advice service is not seen as a core part of the unscheduled care system and is poorly understood across the NHS.
In 2008-09 NHS Direct Wales cost just under £9m and received more than 340,000 calls and 450,000 web visits. Although the costs, which average £26 per telephone call, are comparable to similar services in England, the report says there is scope to improve call handling times.
Some callers are waiting longer than target times to access NHS Direct Wales, with 87.9% of calls answered within 60 seconds after the welcome message during 2008-09.
There is also scope for better promotion of the service, particularly among older people, the report says.
It recommends that NHS Direct Wales should share information on cost and performance to improve understanding of the demand for unscheduled care and support the planning and funding of services.
NHS Direct Wales should monitor patients' behaviour and choices more effectively and take action to support more appropriate forms of unscheduled care, as well as service improvements.
The report says health boards should examine how the service could act as a hub through which patients are directed to the most appropriate pathway for their clinical needs, informing them about how best to access unscheduled care and how to improve their health and well being.
The Welsh Assembly Government and health boards should consider how NHS Direct Wales could help manage chronic conditions, drawing on the skills of its nurse advisers and health information specialists to improve services for patients and provide value for money.
Auditor General for Wales, Jeremy Colman, said: "While NHS Direct provides valuable services which most people seem to like, there is scope for it to be much more effectively integrated within the unscheduled care system, providing a more seamless service for the public.
"I hope the wider NHS will take on my recommendations in order to realise the potential of NHS Direct to help make the unscheduled care service easier for the public to use."
