"A substantial degree of work" is needed to rebuild confidence in the Scottish health helpline NHS 24, according to members of the Scottish Parliament.
The Health and Sport Committee has published a report on out-of-hours care in rural areas that concludes urgent action is needed to resolve shortcomings.
The report recommends that health boards should be given responsibility for delivering coordinated services that meet the needs of their individual communities and are delivered in consultation with those communities.
It also says that while initial problems with NHS 24 have been addressed, patients remain confused about its role and who to access out-of-hours.
Christine Grahame MSP, convenor of the Health and Sport Committee, said: “Out-of-hours services must be fully joined up – and they are not.”
The report was welcomed by NHS 24 and the BMA’s Scottish General Practitioner Committee, which said that many of the recommendations reflect its own policy.
Dr Andrew Buist, deputy chairman of the SGPC, added: “In particular we believe that out-of-hours provision should be better integrated and we would agree that the public are confused about who to contact for out-of-hours services and that this should be addressed.”
The MSPs heard from the Scottish Ambulance Service that patients were confused about the most appropriate route to care. It told the committee it was picking up calls which should be the responsibility of NHS boards.
Others giving evidence said difficulties arose because calls were dealt with by staff in a centralised regional office that did not understand local geography.
NHS 24 and the Scottish government told the committee that there was a general misconception that NHS 24 provided out-of-hours services when its remit extended only to providing telephone triage and assessment.
The MSPs’ report says initial problems with NHS 24 are widely acknowledged to have been addressed and that a much improved service has emerged.
However, it concludes there is still “a substantial degree of work to be done to re-build confidence in NHS 24, in order to ensure that it operates as a fully effective element of the out-of-hours range of services.”
The committee also called for the Scottish government to ensure that quality standards for out-of-hours services were transparent and to address the wide variation in the cost of out-of-hours services between communities.
NHS 24 Chief Executive John Turner said: “We appreciate that the Committee’s report acknowledges the quality of service that NHS 24 now provides to people throughout Scotland.
"We look forward to working closely with our colleagues from partner health boards and the Scottish Government to fully consider the recommendations in the report.”
Health Secretary Nicola Sturgeon said: “While there will always be ways in which the service can be improved, we are convinced that we have in place an out of hours system that works well and which is well supported by NHS 24.
“To ensure continuous improvement, I have asked NHS Quality Improvement Scotland to work with NHS boards to develop national quality indicators for out-of- hours care which will ensure services are consistent throughout the country.
“We will now study this report in detail and consider the recommendations carefully.”