NHS Scotland redesign of urgent care - first national staging review report: 1 December 2020 – 31 March 2021

10. Present and Future NHS 24 Capacity

One of the key risks identified in the NHS A&A Pathfinder Review, was additional pressures on the capacity and performance of NHS 24 by potential significant increased urgent care demand. This risk has since materialised following national Go-Live on 1 December 2020. NHS has experienced considerable strain on the capacity over the week and more lately consistently during weekday in-hours periods and weekends, resulting in increased time to answer (TTA) 111 calls and higher call abandonment rates. This is due to a number of factors, as indicated previously. Despite an extensive recruitment campaign there presently remains a risk to service delivery and further extension of the RUC Programme, including large scale publicity plans and inclusion of the revised urgent care pathway as discussed in Section 7 above and in Annex E.

NHS 24 is undertaking modelling exercises to review capacity, demand and optimise scheduling of capacity to manage existing 111 call demand and future expansion plans for expanding the RUC programme for both adult and paediatric urgent care.

Recommendations – NHS 24 Capacity

• The NHS 24 Board must continue to bear down resolutely on current service pressures and seek to improve time to answer calls (TTA) and call abandonment rates.
• To include ongoing recruitment, retention, staff wellbeing and support, with external support as necessary.
• NHS 24 should undertake a readiness assessment and impact modelling before further national marketing goes live to provide assurance on their ability to manage additional demands.
• Decisions about future expansion, including timing, of the RUC programme, for both adults and children, must be carefully considered by all organisations working with NHS 24 111 and SG, including robust service resilience and contingency measures.