Policy responses and statements
- Name of organisation:
- NHS 24
- Name of policy document:
- NHS 24 Clinical Framework - Draft for consultation
- Deadline for response:
- 14 March 2008
Background: NHS 24 is currently developing a Clinical Framework. This Framework is informed by national and organisational aims but is intended to guide the joint development of services that are geared towards locally sensitive care, delivering the challenges set out in the 'Better Health, Better Care' Action Plan. This document intends to provide a practical set of points around which Unscheduled Care Network partners can discuss, plan, build and assess clinical services.
In developing the Clinical Framework, NHS 24 has had contributions from a range of individuals, from partner NHS boards, voluntary organisations, employees and members of the public at a series of events held over recent months. NHS 24 wished to provide a formal opportunity for consultation, and invited the College to comment on the framework.
COMMENTS ON
NHS 24
NHS 24 CLINICAL FRAMEWORK - DRAFT FOR CONSULTATION
The Royal College of Physicians of Edinburgh is pleased to respond to NHS 24 on the draft NHS 24 Clinical Framework.
The College invited a number of Fellows to comment on this consultation document. It is acknowledged that this is an attempt by NHS 24 to establish an appropriate clinical framework to “extend and develop our [NHS 24] direct involvement with all stakeholders while monitoring and assessing our progress in helping meet the needs of the people of Scotland”.If this reflects a new way forward for NHS 24 to engage more fully with partners within the broader NHS, it is to be welcomed, and some of our Fellows would be happy to be involved in discussions that do indeed promote better patient care. There is, however, also scepticism expressed by some of our Fellows who have been involved in previous negotiations with NHS 24 over the years of its existence in the NHS in Scotland and have not seen the improvements that they have seen as being important.
If this document reflects developments that will both improve and extend the service offered by NHS 24 then expressions of both approval but also concern have been noted. Approval in view of the attempt to engage partners to result in better patient care, but concern because of the potential to increase the activity of NHS 24 when Fellows do not feel that the primary activity of NHS 24, i.e. phone call advice and triage, is not yet completely secure. There is a strong feeling that the core business of NHS 24 should be defined and delivered before there is a view to extend services.
Furthermore, the increasing activity of NHS 24 during the working day is a source of some concern when there is potential for patient confusion about who to contact for health advice when clinicians in primary care should be readily available.
The aspirations expressed in this document have to be reflected in active discussions with the partners that are identified. There are still concerns that the sentiments expressed have been heard before, but if this reflects a real intention to be more responsive to the perceived needs of the service in improving delivery of care to individual patients then it is to be welcomed.
The details of implementation of some of the initiatives proposed are lacking. Furthermore, the validity of information collected has to be proven to stakeholders within the NHS and patients themselves. For instance, we have to be sure that the ways in which information about the patient experience will be collected are robust.
It is suggested that some of the details that will be required should be determined during discussions with the relevant partner organizations at both a local and national level but should definitely include social care departments.
While the need for improved service is undoubted, there were concerns expressed that NHS 24 is adopting a role that it has not taken before and indeed may not be suited, namely that of co-ordinating unscheduled care services. The document states that it is “the first step in a long term plan to provide guidance and support for all partners in the Unscheduled Care Network”, which is not seen by many as a core part of NHS 24 activities. For this to be made reality there needs to be far better engagement on a local basis with other health and social care workers. If this engagement is made real then the issues of risk management, clinical governance, clinical audit, and training will be better addressed in the manner outlined in the document. The issue of risk management is thought to need to further clarification, as the perception of some is that the balance of risk assessment against being completely risk averse has not yet been achieved or even well defined by NHS 24.
In summary, the history of interactions between NHS 24 and some other areas of the NHS in Scotland may have influenced individual responses to this document. The College, however, welcomes many features of the consultation document as an indication of a new way of working that we hope will be implemented in the interests of better patient care. There are, however, concerns about NHS 24 needing to deliver core business objectives prior to extending their present remit.
Copies of this response are available from:
Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.
Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939
[14 March 2008] |
