NHS 24 appears to have improved out-of-hours medical care in Scotland

Patient satisfaction with out-of-hours medical care in Scotland has risen since the introduction of NHS 24 - but it is still too early to judge the long term success of the service. Integrating NHS 24 with existing health services has been more difficult than predicted.

These are among the key interim findings of an evaluation of the introduction of NHS 24 which is being conducted by a team of researchers led by the University of Aberdeen. David Heaney, Senior Research Fellow with the University's Highlands and Islands Health Research Institute, heads the study commissioned by the Scottish Executive to examine the service launched in Grampian, and now covering more than half of the Scottish population.

Mr Heaney, who will present interim findings at the Scottish National Association of GP Co-operatives today (Thursday, May 27) said: "NHS 24 was designed to deliver high quality patient care across the board in Scotland. But the complexity of this task means that the potential benefits of the service are likely to take time to emerge."

"Findings from our evaluation show that the challenge of integrating with existing health services was under-estimated. Early concerns were expressed by GPs in the Grampian area after the service was launched, although there is evidence that NHS 24 has been able to respond to these concerns."

"On the whole, however, we found patients who have used NHS 24 rated it highly and regard it as an improvement."

Comparing those who phoned NHS 24 in Grampian and in Glasgow, to those who had phoned the GP co-operatives pre-NHS 24, the evaluation found that NHS 24 patients were more satisfied with the way they
were spoken to, and the explanation given to them. They felt more listened to and that they had had a
chance to speak. Overall, 62% of NHS 24 patients reported that they were "very satisfied" with the service provided by NHS 24 - compared to 60% pre-NHS 24 when it was a GP co-operative.

A total of 90% were "satisfied" or "very satisfied" post NHS 24 whereas 87% of patients were "satisfied" or "very satisfied" pre-NHS 24. Overall 45% said NHS 24 was better than the previous service, 33% said it was the same, 10% said it was worse than before and 11% were unsure.

The evaluation reports on how a survey of GPs in the Grampian area six months after NHS 24 was launched revealed their dissatisfaction with the service. Areas cited as most problematic were an increase in GPs' workload, uncertainty over the partnership, IT issues and inappropriate prioritisation and triage (the method of assessing callers according to their symptoms).

The study says NHS 24 put in place a series of measures designed to improve interaction with partner organisations and to address triage issues. Views on the service from other partners (Accident and Emergency and the Scottish Ambulance Service) were found to be more positive. To date, the total number of patients using Accident and Emergency or the Ambulance Service has not changed as a result of the introduction of NHS 24.

The evaluation team report that NHS 24 was designed to ensure high quality standardised patient care, delivered across Scotland. But researchers found "becoming the front end of out of hours services has been a much more difficult task than predicted. A number of IT problems emerged. Additionally an existing sense of ownership within GP co-operatives was undermined by integration with a large, national service...

"All this illustrates the size and complexity of the task undertaken in the introduction of NHS 24 into the Scottish health service. The size and complexity of the task undertaken means it is premature to judge the success of the undertaking."