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An internal review of the £47m-a-year service reveals that half of the patients who telephone for help are forced to wait up to 13 hours for qualified members of staff to call them back.
The number of “adverse events”, where patients may have been harmed as a result of bad advice, was seven times higher than the service’s target.
The report also reveals that one in five staff members has resigned since the service was launched and sickness rates are double acceptable levels, mostly as a result of stress and nervous disorders.
Last month Jack McConnell, the first minister, announced a review of NHS 24 after it was revealed that thousands of patients every month were kept waiting to speak to a nurse.
Doctors claimed that a quarter of full-time qualified nursing posts were unfilled. Nurses have left to escape weekend and evening shifts which have grown since new legislation allowed GPs to opt out of out-of-hours medical cover.
However the latest report, presented to the agency’s board a fortnight ago, reveals that problems are greater than previously thought.
Last night opposition politicians called on McConnell to take more urgent action to tackle the crisis. “It is clear that the crisis within NHS 24 is deepening and that ever more serious problems are arising,” said Shona Robison, the SNP health spokeswoman. “There are too many complaints coming in and I am worried that people are going to end up seriously ill because they have been left to wait too long.
“Where patients could have been harmed by these adverse events, which would cover misdiagnosis and bad advice, their cases must be investigated to establish what went wrong.
“The executive must ensure that when people make a call they are not kept waiting for hours and that they get the proper advice. This is a key frontline service and if people lose confidence in it they will just stop using it and turn up at A&E units instead.”
The inquiry was launched by by John McGuigan, the chief executive of NHS 24, in February. It found that 46% of patients had to wait for a medically trained expert to call them back, three times above what the service classes as an acceptable level and nine times worse than in January last year.
It revealed that between December and February there were 15 significant adverse events. NHS 24’s own target is no more than two events per quarter. In February 53 patients made complaints, compared with five last year.
Sickness levels have reached a record level, with 11% of days now lost to illness, which is double the target. The most common reason given by staff is “nervous disorder” and workload is cited as the big pressure.
“It is hardly surprising that the problems identified in this report are occurring because the workload has increased by a factor of 20 in the past 18 months,” said Jim Devine, the Scottish organiser for Unison. “What was initially set up as a helpline has developed into providing support for the whole health service and for the lack of GP cover at night and weekends.”
Last month it was revealed that a woman who called NHS 24 in severe pain was misdiagnosed as suffering from constipation. She decided to go to Dunbar hospital in Thurso where she underwent an operation for acute appendicitis.
In another case Lucy Gordon, from Aberdeen, said she had to wait 13 hours to speak to an NHS 24 nurse after she reported that her three-year-old son had a high temperature.
In a third case, a man was kept on hold for an hour when he tried to get help for his wife who was vomiting and writhing. She was later diagnosed as having gallstones.
A spokesman for NHS 24 said: “NHS 24 has provided a high quality service to almost 2m callers since its inception. However, we recognise that there are always challenges and improvements which can be made to any organisation.”
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