Scots doctors raise concerns over the competence of NHS 24 nurses

GPs hit out at NHS 24 nurses who ‘haven’t seen a patient in years’

GPs are concerned that some patients who use NHS 24
GPs are concerned that some patients who use NHS 24 are being sent unnecessarily to hospitals

Helen Puttick

Published on 7 Mar 2010

Concern that nurses who have had no face-to-face dealings with patients for years are working for the helpline NHS 24 are being raised by Scottish doctors.

GPs are expected to condemn the use of nurses with no recent experience of meeting patients to assess people over the telephone, at a major medical conference later this week.

Dr Georgina Brown, who has flagged-up the issue to the British Medical Association Scotland, said she worked alongside NHS 24 nurses at the Scottish Flu Response Centre. She felt they did not have the confidence to advise patients to look after themselves at home because they had not dealt with the sick, in person, for some time.

She said nurses would send people to hospitals or out-of-hours centres when they did not need medical treatment.

Dr Brown, a GP from Springburn in Glasgow, said: “They are an extremely committed group of nursing staff but a lot of them had not seen a patient in years and I felt it was inappropriate.

“If they spent even half their time in practice and the other half doing NHS 24 that would be more appropriate. Telephone triage is very difficult.”

Dr Brown said she was far more likely to give patients self care advice while her NHS 24 colleagues were more likely to refer them to another part of the health service. She said: “It is because they are following this strict algorithm [of computerised questions] and because they are not used to seeing patients on a daily basis.

“I feel over a period of time, if you do not see patients regularly you lose that level of confidence and clinical skills.”

NHS 24 nurses have a minimum of two years post-graduate experience and the majority are higher-grade nurses who have worked for at least three years outside the helpline, preferably with NHS community or hospital services.

Dr George Crooks, medical director for the helpline, said the call centre nurses were given opportunities to rotate into other clinical areas and many did hold positions in other parts of the health service, such as A&E departments. He added that a review had shown it did not make any significant difference to a patient’s outcome if they spoke to an NHS 24 nurse or GP.

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