NHS 24 bosses paid a visit to Shetland on Friday with a view to developing a local branch of the telephone health service.
Chief executive John Turner said a pilot project in Orkney, the first island community where it had been tried, was going well and in the “next few months” similar arrangements would be explored in Shetland, in partnership with local services.
Mr Turner said the visit, which included a trip to Brae to see the health centre and care centre, would help him and medical director George Crooks to “understand local dynamics to improve the combined offering to the population.”
He said that the NHS 24 service was now well established and although the use by Shetlanders was “relatively low”, it was increasing towards the average as people gained confidence in the system.
Any new service, which would be staffed by local nurses, would be carefully planned with NHS Shetland before being launched and would fit with existing provision.
Dr Crooks said the NHS 24 system of “telephone triage” assesses the patient’s clinical need and takes into account factors such as their age and whether they live alone or in an isolated place. Clinicians at the other end of the phone can then arrange a visit from an out-of-hours GP or district nurse, or advise the patient to go to A&E, call an ambulance or tell them how to manage the situation themselves.
In some cases, patients who have “complex needs” or receiving palliative care can agree for some information about medication or allergies (not complete records) to be passed to NHS 24 so that problems out of hours can receive a quick response. Scotland is the first part of the UK to do this.
Dr Crooks said the “vast majority” of the nurses who work for the service are trained to ward sister or staff nurse level and receive comprehensive training in telephone triage, as well as having mentors and monthly “call listening” sessions.
Everything is recorded and receives “probably the highest level of scrutiny”, he said, unlike a visit to a GP which takes place behind closed doors.
The service also has a mental health team and can even deliver cognitive behaviour therapy by arrangement with GPs.
Mr Turner said the service, which receives 30,000 calls per week, is for anyone needing out-of-hours health care. If not urgent enough to dial 999 the patient should phone NHS 24. “It’s that simple,” he added.
Most calls are answered in three to four seconds and dealt with in 10 minutes.
All mainland Scotland NHS areas already have their own service.