Scottish Daily Mail
NHS24 needs radical surgery says medic who helped create it
A DOCTOR who helped to set up the NHS24 phone line has said its call centres should be ‘dismantled’.
Dr Vijay Sonthalia was on the advisory committee behind the health service helpline in the late 1990s.
Now he has spoken out against i t, claiming too many people are being sent to their GPs by over-cautious nurse advisers in call centres.
Dr Sonthalia yesterday accused NHS24 of adding pressure to the already stretched out-of-hours services by referring people to medics, when they could deal with the problems themselves.
He said: ‘ There is a huge amount of pressure on out-of-hours services and a lot of this pressure is coming from the way NHS24 staff are trained.
‘Personally, I feel this hub (call centre) model is not working and the reason it is not working is the nurses do not get any feedback on their triage.
‘They really should be working in the clinical areas along with doctors and learning on the job. They are working in isolation.’
Dr Sonthalia believes that if nurses are sent to work in the community with doctors this will hopefully show them that fewer cases need to be referred to GPs.
He said: ‘I think a lot of patients complain about dramatic symp- toms and when the GP goes out they are sitting comfortably and it is not as bad as it sounded on the phone.
‘ I think if nurses went with doctors they would see that things are a lot different from how they might sound. Most of the people who call have small ailments and are told just to take paracetamol.’
Members of the British Medical Association’s Scottish GP Committee are expected to back his call to break-up the 111 helpline when he speaks at a major GP conference later this year.
Doctors responding to house calls marked ‘urgent’ by NHS24 staff are expected to be with patients within one hour, but Dr Sonthalia said that in his experience only 70 per cent of people were seen within this time frame.
He added: ‘ A lot of the patients which are triaged to be seen within one hour are inappropriate triage.
‘ We have been f eeding t hat information back to NHS24 again and again.’
Dr Sonthalia admitted that the helpline is not the only reason outof-hours services are struggling. He said: ‘Staffing levels for out-of-hours are not as good as they used to be.’
It was revealed yesterday that family doctors are unhappy that NHS24 staff who have no medical qualifications are giving health advice to patients.
Before NHS24 was l aunched, Dr Sonthalia said at least 50 per cent of patients who called their GP outside of surgery hours were given selfcare advice, but he claims this has dropped to below 30 per cent.
According to him it was originally planned that call centre nurses in Scotland would be given feedback on the treatment received by each patient, but this idea was never fully implemented because of the lack of suitable technology.
Scottish Conservative health spokesman Jackson Carlaw said: ‘The system has to be looked at again, and any overhaul must involve diverting people away from A&E when they don’t have to be there.’
Earlier this week it was disclosed that NHS24’s medical director Professor George Crooks had warned that pressure on staff might be affecting the way they deal with patients. Last night he said: ‘Staff delivering frontline services operate under very close clinical supervision.
‘ We continuously monitor the performance of the service and our staff, as well as the outcomes for patients in partnership with both the Scottish Ambulance Service and GP out- of-hours services in local health boards.’
A Scottish Government spokesman said: ‘A national review of primary care out-of-hours services is under way.
‘This comes more than a decade after the 2004 UK GP contract, which transferred responsibility f or delivery of out-of-hours primary care services to the management of health boards.’