8 November 2006
Systems in Place to Deliver Safe, Reliable Care
The introduction of telephone access and triage as the main route to healthcare services out-of-hours has meant that safe, reliable care can now be provided 24/7 across Scotland, a new report from NHS Quality Improvement Scotland (NHS QIS) has revealed.
The report, entitled The Provision of Safe and Effective Primary Medical Services Out-of-Hours , reviewed the performance of every NHS board against national standards. It examined whether patient access to care is as simple and straightforward as possible (standard 1); whether NHS responses to requests for help are prompt, professional, appropriate and based on clinical need (standard 2); and whether staff providing healthcare services are able to demonstrate that they work together and communicate effectively to deliver the best possible service (standard 3).
The report praises the work of NHS staff in implementing the new out-of-hours system and finds that progress towards full implementation of the standards is generally good. It makes a series of detailed recommendations for each standard, as well as two key general recommendations:
In order to demonstrate that risks are well managed and lessons are learned from experience, risk management and clinical governance arrangements have to be strengthened, particularly in relation to giving information by telephone, and integrated with existing systems, and Key Performance Indicators (KPIs) need to be introduced that demonstrate the quality of care as well as levels of activity. This is work that should be taken forward nationally, with additional local indicators added as required.
Where improvement in performance against a standard is required, NHS boards are required to develop a plan detailing action to be taken against each relevant criterion and timescales for completion. This work is already well underway and the target date for completion of all actions is July 2007.
Commenting, NHS QIS Chairman, Sir Graham Teasdale, said: The introduction of telephone access and triage as the main route to healthcare services out-of-hours has meant that safe, reliable care can now be provided 24/7 across Scotland.
Our review has shown that the old pattern of meeting most patients requests for out-of-hours care by a home visit by a GP has changed. Most people s needs are now met by a telephone consultation with a nurse or a GP, some are seen in an out-of-hours centre and only a minority are visited at home by a GP.
Making this shift in the way care is provided has not been without challenges: different ways of working have been introduced; more effective communication between all care providers has been put in place; new technologies are being used; and a very different way of communicating with patients has been established.
As always, there are further improvements that can be made to the service. Risk management and clinical governance arrangements have to be strengthened, particularly in relation to giving information by telephone, and key performance indicators introduced.
Overall, however, we were impressed by the progress that has been made in every NHS Board and by the constructive and pragmatic approach that has been taken to implement the new out-of-hours services.
Editors Note:
NHS QIS has been established to lead in improving the quality of care and treatment delivered by NHSScotland. To do this it sets standards and monitors performance, and provides NHSScotland with advice, guidance and support on effective clinical practice and service improvements.
A full copy of today s national report and individual reports into the performance of each NHS board are available on our website.
Media Contact: Colin McAllister on 07813 095930