Lack of leadership at NHS 24 leads to shake up

Lack of leadership and problems with responding to peak demand have been identified as key issues dogging the Scottish healthcare helpline, NHS 24, in an interim review of the troubled service.

Vice-chair of Tayside Health Board, George King, has been brought as interim chair to help solve problems outlined in the review and implement a set of recommendations. The previous chair, Christine Lenihan, resigned last week before the review was published.

Head of the review team, Owen Clarke, said that despite criticisms NHS 24 has delivered a generally high level of service. However he reported: “There are some major challenges and several parts of the service need to improve markedly – and quickly.

"One problem has been that expectations of what NHS 24 could achieve were not always deliverable. And although the overall design capacity is sufficient, there are problems with peak demand outstripping ability to respond.

"But there were key barriers to progress and improvement – a lack of leadership, unpredicted pressures due to the new out of hours arrangements, an insufficient pilot period and moving too quickly on the national roll-out.”

Health minister, Andy Kerr, commented: "This report highlights the significant challenges facing NHS 24. We intend to support NHS 24 to meet this challenge head on."

The review team’s recommendations include:

• An examination of the feasibility of several "mini-centres" with specific health boards and with Scottish Executive Health Department (SEHD), having particular regard to the necessary staffing resources required

• Looking at the extent to which NHS 24 can reduce the time taken to get to the caller’s reason for calling

• NHS 24 management must, with some urgency, find ways of reducing more than 300 current shift patterns down to a manageable level.

• SEHD should consider strengthening the senior project management resource within NHS 24.

• The NHS 24 Board must ensure that a review of risks related to call-back (and related implications, eg failure to get through) is undertaken urgently.

• Health boards with remote and rural issues should confer with NHS Highland and NHS 24 to assess the extent to which the new ‘hub’ link would help remote and rural areas generally.

• Senior NHS 24 management should find time to meet more often with front-line staff, to talk with them and, importantly, to listen to them.