Inside Health

Taking pressure off GPS is necessary, but is NHS 24 the answer? asks Kevan Christie

Aseries of trial projects throughout the country which will see patients referred by GPS’ receptionists to NHS 24, which will then decide whether they can see a doctor, has been met with public fury.

This was always going to be a hard sell for the Scottish Government and the NHS in Scotland.

Those phoning the local doctor will initially be at the mercy of the receptionist, who can either grant permission for a same-day appointment or contact the call handlers at the NHS 24 “In-hours GP Triage” programme.

From there, the call handlers – with input from clinicians – will decide the best course of action, either arranging an appointment if the patient’s problem is deemed worthy enough of a GP’S attention or deciding the person need only see a pharmacist.

A third option is to point them in the direction of the NHS webchat service and self-help guides.

The general thinking behind this, and the way it’s been spun, is that local doctors will have the opportunity to have more face-to-face time with their patients – the “genuine” ones – now that the timewasters and “worried well” have been fobbed off with a leaflet and others who are unwell, but not seriously, have been redirected to the chemist.

As part of the service, NHS 24 “promise” to call back every patient who has phoned their GP in the morning by 1:30pm to tell them if their bid to see a doctor has been successful.

So, it’s maybe a bit like the plumber telling you he’ll be there in the afternoon to fix that leaky tap.

There is a concern that vulnerable patients and those without the internet could suffer and choose not to engage with this process.

The benefits of seeing someone who is medically qualified eye-to-eye cannot be ignored, particularly as patients can sometimes have a more serious, underlying problem than they realise. Older people in particular value face-time with their doctor.

The trials come at a time when there are huge pressures on general practice and the thinking behind the idea ties in with the Scottish Government’s multi-disciplinary approach to healthcare, in which a patient can be treated by any number of a wide range of medical professionals, from nurses to physiotherapists, in their area.

The worry is that this initiative, built around a “transformation” of primary care, is nothing more than an excuse not to provide GPS with the funding and support they really need.

In terms of the ongoing GP recruitment crisis, it doesn’t take a cynical journalist to work out that cutting down on the number of appointments will help medical surgeries struggling to cope with a lack of staff and relying on locum doctors.

However, the initial trial for the GP triage project at a practice in Forth Valley was deemed to be “highly successful”, according to Dr Laura Ryan, the medical director of NHS 24.

And some people have apparently found it is easier to get a doctor’s appointment using NHS 24 than when taking their chances with the local practice’s booking system.

Certainly if it works – and it’s a big if – it will see pharmacists and other perfectly capable health professionals taking on a wider role in providing care.

The key to all of this, as with most of the developments in the health service at the moment, is to change public thinking around the levels of service they expect from their GP.