Kerr Report expert: Bolster NHS with 'army' of volunteers

Prof Kerr, the expert behind 2005's landmark Kerr Report on the future of the Scottish NHS, said the service could be modelled on the role that Territorial Army reservists play in fortifying the Armed Forces.

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However, Prof Kerr stresses that there is "deep well of experience can be tapped in a more consistent way" in order to to increase the proportion of patients who can be cared for safely at home, reducing pressure on overcrowded hospitals.

He said: "The NHS is currently facing the greatest challenge in its 75 year history.

"What we desperately need are practical solutions which can help our most treasured national institution survive and thrive over the coming years.”

“That is why we are proposing today that UK and Scottish Governments should come together to create a Citizens Health Service made up of volunteers and retired healthcare workers who can support patients at home or respond to people when they’re in need.

"If we are to keep the NHS going we should summon up the ‘pandemic spirit’ when thousands of folk stepped forward to help frontline workers.

“We also want to see our governments do more to help patients look after themselves: most of us don’t want to go to hospital and we should be doing more to support people to remain at home.”

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The report was commissioned by Our Scottish Future, the think tank founded by former Prime Minister Gordon Brown.

It comes as figures this week revealed that around one in seven Scots is on an NHS waiting list for an inpatient admission, outpatient appointment, or a diagnostic test.

The number of people waiting for an operation has nearly doubled from an average of 77,000 in 2019, to nearly 142,000 by the end of September this year.

This figure includes 7,612 patients who had been waiting over two years for a procedure.

The number on outpatient lists has also ballooned from just over 308,000 before the pandemic to a record 474,600.

Lengthy delays for treatment increase the risk of patients deteriorating and becoming unwell, resulting in emergency admissions to hospital.

Retired nurses were among those who returned to help with the pandemic response (Image: PA)

The problem is exacerbated by shortages of district nurses, physiotherapists and home care staff to support sick and elderly people in their own homes.

Official figures indicate that more than 12 per cent of district nurse posts in Scotland are empty - rising to 30% in Lothian - with around one in 10 NHS physiotherapist posts vacant.

Scotland's care sector also has an estimated shortfall of 17,000 workers, with more than 70% of home care providers struggling to fill vacancies.

In his report, Dr Kerr points to the Covid pandemic response - where thousands of retired nurses and doctors returned to support the rollout of testing and vaccinations - as an example of what can be achieved.

He writes: "While accepting that this was a clarion call to duty, we feel that the rapidity with which this work force assembled demonstrated an enormous willingness to continue contributing to the nation’s health.

"So this paper proposes that, across the UK, we form a training and education corps of retired healthcare professionals and a volunteer force that we can educate across different divisions depending on need.

"We believe that this deep well of experience can be tapped in a more consistent way. And we believe we can link it to the construction and training of a new Citizen’s Health Service (CHS), not dissimilar to the role the Territorial Army plays in our Armed Forces."

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The report suggests that people drawn from the local community could form a "volunteer army of first responders" who would be "trained and supervised to provide basic, preliminary healthcare" - particularly in rural areas where resources are more thinly spread.

This might include responding to car crashes or being dispatched to the home of an elderly person who has suffered a fall.

The report adds: "These individuals would assess the extent of the health problem and take steps to de-escalate a situation to prevent further injury or incident.

"They may provide life-saving care to persons injured or ill, or transport to those who need additional attention to a medical facility."

It calls on the UK's four NHS services in Scotland, England, Wales and Northern Ireland to "join together to create a nationwide training programme for first responders".

Helping people to stay well at home for longer is a priority to reduce pressure on hospitals (Image: PA)

In addition an NHS "reserve force" of volunteers should be on standby to assist health and care services in the event of an emergency, said Dr Kerr, adding that they could be offered incentives such as access to education or "discounted cake and coffee" to sign up.

The report also advocates for a greater number of patients, especially those with long-term chronic conditions, to be "more actively involved" in their own care through an "increasing focus on the use of remote monitoring and telemetry to alert patients and their health teams to changes in disease status".

Since 2020, the Scottish Government has invested £8.1m in hospital-at-home services which enable patients to receive intravenous drips, oxygen or tests in their own home, while being monitored remotely by a hospital consultant.

Remote monitoring - for example of oxygen levels - is associated with a substantial reduction in hospital admission and lower healthcare costs for elderly patients with acute worsening of chronic bronchitis.

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This type of hospital-at-home care is also a "viable alternative" for elderly patients with a sudden deterioration in chronic heart failure, said Dr Kerr.

He added: "Increasing care at home is a win-win: not only is it better for most patients, it also has the potential to save tens of millions of pounds, which can be dedicated to improve acute care."