DOCTORS in East Lancashire are to get together with NHS Direct nurses in a radical rethink of the out-of-hours doctors' service.

The new East Lancashire-wide service called the Exemplar Project is one of the first shake-ups of doctor services in the country.

Only a handful have already tried the scheme, which works in partnership with NHS Direct, and is what the Government wants to see in all areas by 2004.

Patients in the area had a taste of the changes when the project went live for a test period between midnight and 8.30am, the quietest time for calls.

It was hailed a success, with only a few minor teething problems with technology.

The change is being set up between the three local Primary Care Trusts - Blackburn with Darwen, Hyndburn and Ribble Valley and Burnley, Pendle and Rossendale - and the local NHS Direct call centre, which will run a "mothership" where all calls come in.

When a patient rings their surgery out of hours, they will be put through to NHS Direct, which will pass them to trained nurses to deal with the calls and decide how best to go forward, depending on the seriousness of their condition.

Project manager Max Harrison said: "It will cover the whole of East Lancashire and the call handlers are trained to look at calls and see what is life threatening and deal with those immediately.

"Everybody is very keen for this to work. We wanted to get involved as soon as possible because it seemed like a very good idea. The NHS Direct nurses are all trained to work to the same standard so we know that the quality is going to be right."

It will replace the five out of hours services for the area, Blackburn and Darwen Medical Co-op, Burnley and Pendle Co-op, Burnley and Pendle Primary Care Centre, Ribblesdale Emergency Services and Radio Doctor.

Organisers wanted to be one of the first in the country to set up the service because they thought it would be a big improvement for both patients and doctors.

They believe the service will be better, more efficient and mean patients only have to make one phonecall.

It will also mean less of the responsibility for out of hours will fall to GPs, as many of the calls can be answered with advice from trained nurses over the telephone.

Although NHS Direct staff will be dealing with the calls, organisers stress patients must continue to call their doctors' surgeries, where their calls will be put through automatically as a priority.It should also mean better communication using 21st century technology, as the "mothership" will use computerised patient records and will be able to email or fax practices to let them know when they have dealt with a patient.

No-one at NHS Direct was available for comment.