NHS 24 May Give GPs Day Cover

Helpline NHS 24 could handle calls to GPs during the day to help surgeries open in the evening. The medical phoneline’s new chief executive, Sandy Forrest, said its nurses could play a key role in extending GP practice hours – one of the aims of Health Secretary Nicola Sturgeon.

Some doctors already divert their phones to NHS 24 during the day on occasion so they can undertake training.
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However, any move linked to the creation of evening surgeries is likely to be controversial. GPs have been among the biggest critics of NHS 24 and are also sceptical about the benefits of offering late appointments.

Barbara West, GP and secretary to Glasgow Local Medical Committee, said: “Much higher on my list of priorities is that NHS 24 does the work it does correctly, properly and efficiently.”

There were major problems at the phoneline when it began handling calls to GPs outside surgery hours in 2004/05 and some patients waited hours for nurses to ring back with advice.

John McGuigan, the last chief executive, is largely credited with getting performance on track, although there are still some outstanding issues, including high staff turnover and absence rates.

Mr Forrest, a former deputy chief constable who took up office in May, is advancing the helpline’s plan to use its call centres in new ways to assist the NHS. He believes building its daytime role could make jobs there more attractive and help deal with the internal staffing issues at the same time as benefiting the health service as a whole.

At the moment the vast majority of staff are deployed at evenings, weekends and holidays with just 7-10% working on a typical weekday.

Mr Forrest said: “What there is the capacity to do is to use the infrastructure in hours to make a contribution and at the same time provide a role that is interesting for nurses in a way that perhaps tackles the recruitment and retention issues.”

Possibilities include nurses contacting patients before planned operations to ensure they are fit for the procedures and to remind them to fast if necessary. A support line for patients managing long-term health problems has also been discussed.

In addition, Mr Forrest said: “We have the government wanting to talk to GPs about extended GP hours. That is also not inconsistent with the developing role of NHS 24. It fits in the other way at the moment that we provide in-hours care for protected learning. We are already coping with situations where in one small area at a time the GP services are not required during the day while protected learning is going on.”

Pressure for GPs to consider offering appointments outside working hours has been growing both north and south of the border.

Writing in The Herald last week, Ms Sturgeon said: “If it suits a patient’s employment or childcare arrangements to see a GP or other member of the primary care team in the evening or at weekends that should be possible.”

However, Dr West said there was “no enthusiasm” for extended opening hours in the medical community.

She said: “Our role is geared very much to the young, the old and the chronic sick. They do not want to come out at 7pm at night.

“This (extending hours) is an argument put forward for people who commute long distances and get home late. But if people want to see their bank manager or solicitor they are going to have to take time off work . . . no-one bats an eyelid about that.”

A spokeswoman for BMA Scotland said NHS 24 had improved in recent years, but added: “We need to make sure that the service can cope before it looks at adding more on to the work that it does.”

She said GPs do not have the detail of proposals on extending surgery hours, but were happy to debate the issues.