Exclusive: Kate Foster

30 May 2010

Patients will be assessed by nurses instead of consultants and spend less time in hospital under controversial cutbacks to meet waiting time targets in Scotland.

Many follow-up appointments will be scrapped altogether and patients could be discharged from hospital at weekends under the scheme.

The groundbreaking plans to “streamline” the NHS have been revealed as hospital managers prepare to meet an ambitious target that no patient should wait longer than 18 weeks from a GP referral to the date of their operation.

The move will allow thousands to be treated faster but last night doctors and politicians raised fears it could compromise patient care.

The sweeping changes have emerged in official advice to NHS managers from the Scottish Government’s 18-week Referral to Treatment Time Programme, staffed by doctors and health officials.

Key changes proposed by the experts, revealed in a briefing to health boards, include using specialist nurses and health professionals such as physiotherapists to “reduce consultant appointments” by assessing whether the patient needs a specialist or just requires advice.

Nurses will also be trained to carry out some follow-up appointments and many outpatients will be seen at weekends.

The advice also states day surgery should be “the norm” rather than traditional overnight stays and patients discharged “as soon as they are ready”, including weekends which previously hospitals have avoided due to scarce community services. Health boards are also told to eliminate unnecessary follow-up appointments by scrapping them or replacing them with phone calls.

The move applies across all specialties for non-urgent patients as part of a £230 million three-year scheme to improve NHS infrastructure.

Managers must consider making the changes to free up consultant appointments and hospital beds.

Follow the link to read more about plans to replace consultants with nurses in  NHS Scotland