NHS 24 To Deal With 999 Cases Under Controversial Plan

Thousands of patients who dial 999 for an ambulance will be called back by NHS 24 staff under a controversial new plan linking the two emergency services. The move, planned for the spring, would result in the least-urgent 999 cases in Scotland being dealt with by the helpline’s nurses over the phone, rather than being responded to by ambulance crews.

Doctors have expressed reservations about the plan, which will join the well-established Scottish Ambulance Service with an organisation that could not cope with demand just two years ago.

NHS 24 hit crisis when it took over calls to GPs outside surgery hours and a catalogue of criticism was levelled at the service following a fatal accident inquiry into the deaths of two people.

The proposal to hand 999 callers to NHS 24 has sparked speculation that the two bodies will eventually be amalgamated into one. The services already have the same medical director. Dr George Crooks, who has held the post at NHS 24 since September 2005, also became interim medical director of SAS last autumn.

Dr Crooks said: “At the moment, we are still asking patients to make a decision about which part of the service they need to access, NHS 24 or the ambulance service, at a time when they are panicky and worried about themselves or a neighbour or family member.

“Common sense at these times sometimes goes out the window. People will sometimes make an inappropriate choice and we should not blame them for that, so we have to have a way of making sure we can route patients to the most appropriate end point. Rather than expecting if you phone 999 you always get a white van and two men in green suits, we have to flow patients through the system.”

In a pilot scheme, two NHS 24 nurse advisers sat in the Edinburgh ambulance control room and dealt with 999 patients. It is claimed this trial demonstrated that 15% of calls to the ambulance service could be handled by NHS 24, the equivalent of 5250 to 6000 calls a month across Scotland.

Now the technology to pass patient information from the ambulance service to NHS 24 nurses is being developed, so people who dial 999 will not have to repeat details of their health problem when they are phoned back.

But Dr Alan McDevitt, secretary of Glasgow’s GP committee, said he had anxieties about the reform. “Obviously assessing a patient on the phone is a little more risky, because it is always more risky not to see a patient in person. And people’s perception of NHS 24 is still that it is an obstruction to getting care but it comes down to how clever they are that it is the right people they divert (from one service to the other).”

However, Dr Andrew Buist, deputy chairman of the British Medical Association’s Scottish GPs committee, said he was comfortable with the idea. “Provided the clinical condition of the patient is properly assessed by telephone, then it is appropriate we do this on the grounds that we have a finite amount of ambulances and we have to make sure that those most in need of them get them,” he said.