The Scottish Government

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INTRODUCTION

On 24 February 2005, the First Minister announced in Parliament that an independent review group was being set up "to identify performance improvements that should be implemented by NHS 24." The Minister for Health and Community Care followed up that announcement by adding "we want to make sure that all our services give the best possible performance for patients and that patients have confidence in those services."

The Review Team's remit is to produce a report and recommendations for action - including actions for NHS 24, NHS Boards, other partners and the Scottish Executive Health Department (SEHD) in relation to:

• Improving responsiveness of NHS 24 to callers and waiting times for service users;
• Reducing the use of 'call-back';
• Improving services for patients in remote and rural areas;
• Providing seamless and effective handover of patients as they move between NHS 24 and its NHS partners;
• Staff and staffing issues.

The Review Team was asked to produce an interim report by the end of May 2005, and a full report by the end of September 2005.

In preparing this interim report, despite admirable commitment by every member of the team, we have not had a lot of time to examine in any great depth all of the issues around why NHS 24's performance - which was generally regarded as at least satisfactory - took a turn for the worse at the end of 2004. This interim report provides an outline sketch of NHS 24 and illustrates the problems and challenges it is now facing. Both in this report and in the final report we shall enjoy the benefit of 20:20 hindsight - but in a few instances we shall legitimately question the foresight and judgement of some senior management and Board decisions.

Over the last 9 weeks, we have met and contacted some NHS 24 front line staff, managers, directors and non-executive directors (including the Chair). We have looked at Board minutes and supplementary papers. We have met several former employees of NHS 24 including one Chief Executive. We have met senior officials (and former officials) of SEHD. We have spoken to one Health Board Chairman and 2 Chief Executives. We have met senior officers of the Royal College of General Practitioners and we have been invited to attend a relevant part of a BMA (Scotland) conference. We have had 2 full meetings of the review team, the second of which considered the content of this report.

On the basis of our preliminary findings we are making several recommendations on what must be done in the short term to restore confidence in what remains a very worthwhile service, but one which needs to improve its performance markedly - and very quickly - in certain areas. During the course of the next few months in preparation for the full report, we will be examining the underlying issues in greater depth. We shall also be observing NHS 24's performance in a number of key areas both in the light of the recommendations we are making and of a number of initiatives already instigated by the new Chief Executive and his executive team. We shall also examine whether and when important enhancements that were envisaged in the original design but which, rightly, have not yet been implemented should be considered - eg links with social services and on-line health advice.

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