Patients who call NHS 24 will now be able to speak directly to a GP after a Covid-19 trial led to a drop in visits to under pressure out-of-hours services.
Changes in the way emergency cases are triaged in the evenings and at weekends to minimise virus transmission risks are to be made permanent by NHS Greater Glasgow and Clyde (NHSGGC).
Under normal circumstances a patient calling NHS 24 will be advised by a nurse go to A&E, an out-of-hours centre or given self-care advice.
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Under the new system, in potentially more serious cases a GP will now carry out a consultation over the phone to decide if an urgent appointment is necessary. Anyone without a referral will be turned away from out-of-hours centres.
The health board has increased the number of doctors staffing the service with some only making calls while others based at out-of-hours centres are speaking to patients between face-to-face appointments.
NHS Greater Glasgow and Clyde say the new system aims to cut waiting times for patients, reduce virus risks by limiting clinic visits and may help address chronic staffing issues at out-of-hours centres. Some GPs, including those who are shielding themselves, have been carrying out telephone consultations from home.
The board stress the new system will not replace necessary face-to-face consultations and home visits will continue, where necessary. A number of other Scottish health boards are said to be introducing a similar system.
Dr Kerri Neylon, Deputy Medical Director for Primary Care and a practising GP, said: “The Covid-19 pandemic has made all health services consider how they manage to deliver patient care whilst trying to meet demand and none of this is easy.
“What we know is that we cannot have waiting rooms full of patients and their families and carers.
“We also cannot ask people to shield for many weeks and then bring them into waiting areas with lots of other people.
“The out-of-hours service is an urgent care service for patients who are unwell and cannot safely wait to contact their usual GP Practice.
“The evidence shows that around 20-25% of calls to NHS 24 can be managed with self-care.
“The out-of-hours service in GGC has a number of advanced nurse practitioners and GPs who are only carrying out phone consultations.
“Clinicians who are based in urgent care sites are also carrying out phone consultations in between seeing patients face-to-face.
“Providing a telephone consultation will often be sufficient for many of our patients and is not a way of “not seeing” patients, as evidence shows that phone appointments can last as long as those face to face.
“Initially what we are trying to do is call back all patients within four hours but our aim would be to call them back within an hour. We are hoping that we have enough people to manage that.
“We have found that actually the number of people that have to come into centres is much reduced.
“It’s about being very clear that we are an emergency service, for problems that cannot wait until the next day.
“The model also allows clinicians who currently are unable to see patients an opportunity to work and continue to use their extensive skills.”
The health board is also in the process of rolling out video consultations for daytime GP appointments, again introduced to minimise virus transmission risks.
Dr Neylon said: “It’s also about making sure that if we are bringing that person into the site it’s because we need that face-to-face clinical examination.
“We have to consider virus transmission going forward.”
NHSGGC runs out-of-hours services at Stobhill and Victoria hospitals in Glasgow, the Royal Alexandra Hospital in Paisley, and Inverclyde Royal Hospital in Greenock.
In February, the board was forced to suspend all out-of-hours services at five centres due to a lack of GPs.
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