Scottish patients who call 999 for an ambulance may end up being called back by staff from the information and advice line, NHS 24, from this spring.

A new IT system is being developed so that details of non-urgent calls to the ambulance service can be passed electronically to NHS 24. Its nurses will phone 999 callers back and already have some details of their condition.

A Scottish Ambulance Service spokesperson told E-Health Insider Primary Care that the software is being developed to replace the current criteria-based dispatch system, allowing call handlers to e-mail caller information for patients they believe need to speak with a nurse before paramedics are called.

The benefits would be that patients will no longer be told to redial NHS 24 and repeat information they had previously given the 999 operator – however it could take up to an hour for an NHS 24 nurse to call a patient back.

The move follows a successful six-week pilot study in Edinburgh last October and November, which found that up to 15% of calls to 999 could have been handled by the helpline.

NHS 24’s clinical director, Dr George Crooks, said: “At the moment, we are still asking patients to make a decision about which part of the service they need to access, NHS 24 or the ambulance service, at a time when they are panicky and worried about themselves or a neighbour or family member.

“Common sense at these times sometimes goes out the window. People will sometimes make an inappropriate choice and we should not blame them for that, so we have to have a way of making sure we can route patients to the most appropriate end point.”

The plans have been greeted with scepticism by members of the Scottish Parliament, who expressed concerns that the phoneline will struggle with the added pressure, as it did when it was first launched. The new arrangements could apply to up to 6000 calls a month.

The Scottish National Party’s health spokesperson, Shona Robison, said: “I worry that some genuine emergencies could be missed because of poor communication from the patient or between the ambulance service and NHS 24. Someone could be left when it would be appropriate for an ambulance to be called out.

“We have just managed to stabilise NHS 24 and it is moving forwards and the major problems that have dogged it in the past seem to have been resolved. Immediately they have been given another major task to do. I just worry this may be a situation of making them run before they learn to walk.”

The Scottish Conservative health spokesperson, Dr Nanette Milne, added: “We are giving it a cautious welcome, although concerns remain about the prior performance of NHS 24 which was rolled out without proper piloting, despite promises to the contrary. That must not be the case here.”

The Patients Association also expressed concerns about the new plans, which will see operators deciding the severity of a patient’s illness.

A spokesperson told the Scotsman: “They [patients] should not have to explain why they need an ambulance, which takes up valuable time when time is very important and then wait to be called back by someone at NHS 24.

“If the operator is saying ‘do you really need an ambulance?’ and the patient is in a distressed state, how can they be expected to answer? This could end up costing someone’s life.”  

The plans have been supported cautiously by the British Medical Association’s Scottish GP committee whose deputy chairman, Andrew Buist, said: “It is certainly something that we should be looking at cautiously and positively. It will release capacity for the patients who must get an ambulance quickly.”

A Scottish Executive spokesperson stressed that there were no plans to amalgamate the Scottish Ambulance Service and NHS 24.

They added: “This welcome development recognises the close working partnership that exists between these two complementary organisations and the excellent working that exists in NHS Scotland. It is about improving clinical services for patients and enabling both organisations to make the best use of their resources.”



NHS 24

Scotland Ambulance Service