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CAMHS won't see you now

Pay evidence slur provokes GP fury

An independent review says criticism of the healthline is justified and concludes a radical redesign is needed

By Daile Pepper

NHS 24, Scotland's nurse-led healthline, must undergo a radical redesign, an independent review team has concluded.

In its final report the review ordered by the Scottish Executive said the general level of service provided had been high but highly inconsistent, sometimes ‘very bad' and that criticism was justified.

GPs and patients have raised a series of concerns, chiefly about lengthy call-back times. The review team said NHS 24 needed to reassess current

demands and recognise that doctors and nurses would

continue to be scarce resources'.

‘The board of NHS 24 needs to think radically, to look beyond the original design blueprint which no longer matches the needs of today,' it concluded.

Problems coping during peak times, difficulties in the recruitment and retention of nurses and difficulties in helping people calling from remote areas were highlighted as particular problems.

The risks associated with the persistent use of call-back – rather than on an exceptional basis – from just three national NHS 24 call centres combined to overwhelm the service.

The report said health boards must recognise progressively fewer GP would want to cover evening and night shifts.

He said: ‘It is imperative boards progress as quickly as practicable to develop nurses and allied health professionals who can play a full and important role in unscheduled care.'

Dr David Love, GPC Scotland joint chair, welcomed a recommendation that the effect of more local call handling should be investigated.

‘It could help address the current recruitment problems and ensure closer partnership working between local out-of-hours organisations and health boards with NHS 24,' he said.

Dr Dean Marshall, Lothian LMC secretary, said most GPs were disappointed in the performance of the service but said few had confidence it could be made more responsive without becoming more local.

‘GPs previously used to cope with the demands of the public and call-back was used on very few occasions,' he said. ‘In recruiting and retaining staff we always felt that having a kind of local network you would be far more likely to retain staff.'

Argyll and Clyde LMC secretary Dr John Ip said if GPs had been listened to many problems could have been avoided.

NHS 24: report findings

• Service highly inconsistent and criticism justified

• Use of call-back is not a solution to high call volumes and creates more problems

• Radical redesign of service needed with reassessment of likely demand

• Revamped service must recognise progressively fewer doctors work out of hours

• Plans for ‘hub and satellite' models must have clear and measurable objectives

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