| Description | Final Report of the NHS 24 Independent Review Team. |
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| ISBN | (Web Only) |
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| Official Print Publication Date | |
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| Website Publication Date | October 05, 2005 |
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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 hand-over of patients as they move between NHS 24 and its NHS partners;
- staff and staffing issues.
An interim report was sent to the Minister at the end of May. It can be found on the Scottish Executive website at www.scotland.gov.uk/Publications/2005/06/InterimReportNHS24. We shall not repeat in this final report everything that was in the interim report (which was largely about looking back at why, when and how some major problems arose) but the salient points will be covered as we look much more in this report at the present and to the future.
In our interim report we also freely admitted to our regular use of "20:20 hindsight" and that continues here. As with the interim report we do not criticise any individual employee or ex-employee of NHS 24. Where we are critical it is of the organisation as such. We have also said from the beginning that it is not possible to review the performance of NHS 24 in a vacuum; it is essential to take account of its impact on the performance of all other relevant NHS partners - and of their impact on its performance. That is endorsed by the width of the Minister's remit to us.
NHS 24 is now an essential service provider partner within the NHS in Scotland. Following the introduction in 2004 of the General Medical Services contract, when GPs were given the right to opt out of responsibility for providing out-of-hours (OOH) patient care, it assumed a central role in the Scottish Executive's plans for providing OOH care throughout Scotland. But there have been, and remain, a number of problems and challenges. One or two of the former are quite serious and some of the latter very difficult. Over the last 5 months or so we have consulted several hundred people across a wide range: staff and managers in NHS 24 ,senior officials (and former officials) of the Scottish Executive Health Department (SEHD), every Health Board (Chair and/or senior officials), representatives of the British Medical Association, the Royal College of General Practitioners, the Royal College of Nursing, the voluntary sector in Scotland, the Association of Accident and Emergency Medicine, the Scottish Ambulance Service; Board members (Executive and Non-Executive) of NHS 24, remote and rural GP practices - and many other people, patients and patient representatives groups. We have very much appreciated the friendly but open and frank discussions. We have had many comments, some tributes and many complaints, from the public about the standard of service. There is much support for the concept of NHS 24 and a general appreciation of its value to the NHS in Scotland but there is not a group we have consulted which has not been adamant that the standard and consistency of service that NHS 24 offers to the people of Scotland - particularly out-of-hours when most GPs are not on call - must improve in certain areas.
In our interim report we made 12 recommendations - including 6 for action by NHS 24 alone and 5 for action by Health Boards, or by Health Boards and NHS 24 together. It is already clear that progress has been made on all of those recommendations and that there is real commitment at the most senior levels. In this report we emphasise the need for the same levels of commitment and trust at all levels of Health Boards and Special Health Boards.
The change in attitudes and relationships between NHS 24 and Health Boards, and vice versa, is very welcome. NHS 24 is now clearly showing that it is prepared to consider change - radical change where that is needed - to allow a more consistent level of quality service to callers in urgent need of help and advice. At the centre the SEHD has been exhorting much more specific and proactive mutual help and support and Ministers are making it clear that they will in turn hold Boards accountable for their part in realising genuine, 'joined up' partnership working, particularly in primary care, across NHSScotland.