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Night on the frontline at NHS 24 call centre How troubled service coped at busy festive period
(Evening Times Via Thomson Dialog NewsEdge)Extra staff have been hired to ease pressure in the troubled helpline over the festive period following chaos last winter. Health Reporter JOHN McCANN visited one call centre to see how staff were coping
IT'S 7pm at the NHS 24 call centre in Clydebank and a patient's life hangs in the balance. A woman has gone to a relative's house to find she is suffering symptoms of a heart attack.
Within seconds, nurse adviser Lorraine Gourlay has sent an ambulance.
Yet a few days earlier, at one of the busiest times of the year, a colleague of Lorraine had to advise a woman whose "health problem" was just a dirty fingernail.
NHS 24 has been reorganised since the arrival of new chief executive John McGuigan last year, streamlining calls so the most urgent are dealt with first and encouraging the public to phone during office hours if they are not unwell.
The complicated questions that frustrated many patients, parents and staff are now seldom used and nurse advisers with years of experience can offer help fast.
Call handler June Gordon said: "Some people will never be happy - no matter what we do.
"Worried callers want to see someone quickly but we need to know where the patient is to get help to them.
"It's a balance between not delaying the patient and making sure we have enough information to help."
A perfect example arrives seconds later, when a woman calls to say an elderly relative is unwell. The patient has had a heart attack before and looks a bit grey.
June immediately passes the call to Lorraine, who speaks calmly to the caller, while typing a brief alert on her computer screen. Within seconds, she calls the ambulance service, requesting a "blue light" response.
Details of the woman's age, condition and medical history are with the ambulance crew.
Less than a minute after June spoke to the caller, help is on the way.
Despite NHS 24's huge workload - 40,000 calls over the Christmas long weekend - response times have improved markedly.
In the busiest period, which rated alongside New Year when GP surgeries again closed for four days, the most urgent cases were seen ahead of target.
On average it took 24 seconds to answer a call on Boxing Day, rising to 62 seconds on Christmas Day, still within the twominute target.
Staff planned to phone back 90-per cent of "serious and urgent" cases within 20 minutes - and achieved 94-per cent. For slightly less urgent Priority 1 cases, 91-per cent were contacted within 60 minutes, just ahead of target.
NHS 24, which is based at three call centres, has been dogged by controversy since its launch in May 2002.
In the past three years complaints have flooded in about lengthy call-back times and alleged poor advice.
Staff quit in droves because of the pressure and the service was put under added pressure because of changes to out-ofhours cover at the end of 2004.
However, the Executive, which demanded changes after an independent review last year, says the service is here to stay.
At Clydebank, senior nurse Joe Watson has the job of ranking patients waiting for a call back according to priority.
His screen shows 20 cases, from Elgin to Hamilton, each with a line on their condition.
Skipping through the boils and toothaches he stops suddenly.
"Hang on, that shouldn't be there, " says Joe. A patient has blotches on the face.
Joe walks to a nearby desk to grab a nurse adviser, who calls the patient's family.
Joe, a former accident and emergency nurse, says: "The spots are around the patient's mouth so it could be an allergic reaction, which can be fatal."
However, the patient is not in distress and is breathing normally.
Tonight it's the Clydebank centre's turn to take on "the Business" - overall control of NHS 24 across the country.
At the 9pm peak, 192 calls are received in 10 minutes.
CLINICAL service manager Kathy McLean diverts staff and nurse advisers to take initial calls and deal with a backlog which is emerging.
Within an hour, response times are back on track.
Surprising calls include the parents of a six-year-old boy bitten by a hamster - it may be wise for him to have a tetanus injection.
Other queries are a less worthwhile use of the lifesavers' time and Kathy does well to hide her frustration at some of the demands on her staff.
A call handler pipes in: "We had a call at the weekend with someone saying they had dirt under an acrylic fingernail."
Other strange calls have included a patient who had dropped their dentures down the toilet - "eat soft foods and see your dentist" was the advice.
NHS 24 spokeswoman Caroline Weintz says: "People don't seem to realise the out-of-hours service is for ill people. But the message is starting to get across."
TIMES FILE A SNAPSHOT of conditions reported to the out-of-hours centre included:
Chest pain - always treated as a heart problem until details suggest otherwise Breathing problems Toothache that had bothered patients between one and three weeks Boils on the face or neck Piles Patients seeking advice on prescription drugs
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