Out of hours primary care services in Scotland
1 April 2014 to 31 August 2023

About this release

This release by Public Health Scotland (PHS) provides an update on Out of Hours (OOH) Primary Care (PC) service activity from 1 April 2014 to 31 August 2023. COVID-19 Hub/ Assessment centre activity is included from March 2020 until March 2022, as this was managed by the OOHs PC services in the out of hours period. Accident and Emergency (A&E) attendances during the out of hours period are also presented. In August 2022 there was a system outage, which meant that for a number of months PHS did not receive any OOH activity data from NHS Boards. Although the system was reinstated by late 2022, the flow of data to PHS was not fully re-established until late summer 2023. Due to very incomplete data for August and September 2022, activity for these months is excluded from the publication.

Main points

• There has been an increase in the total number of OOH PC consultations in the first six months of 2023 compared to 2022 (up 4%); this is notably higher than pre-pandemic OOH PC consultations (16% higher than the same period in 2019).
• The number of unplanned A&E attendances in the out of hours periods has increased over the same time period in 2023 and 2022 (up 1%), but decreased compared to the same period in 2019 (11% lower). The A&E attendances data in the publication is based on unpanned data only and excludes New Planned attendances introduced as part of the Redesign of Urgent care in 2020 as well as other planned attendances. Therefore not all A&E attendances are included.
• The implementation of Redesign of Urgent Care and introduction of new pathways may be having an impact on contacts with PC OOH services however it is difficult to interpret what those impacts are.
• More recent trend data on comparison of A&E attendances to OOH PC consultations looks markedly different to older historical patterns (January 2017 to February 2020).
• The ratio of consultations to cases rose during the COVID-19 pandemic which was driven by a higher use of telephone consultation. This fell after the COVID-19 community pathway was closed at the end of March 2022 and continued to fall from June 2022 when a more accurate method of identifying cases was introduced.

Monthly number of cases/consultations in OOH Primary Care and attendances at A&E (Out of Hours period only) NHS Scotland, January 2017 to July 2023

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Monthly OOH Primary Care activity and A&E attendances - Scotland (Out of Hours period), January 2017 to August 2023

• Pre pandemic, consistently nearly six out of ten consultations took place in a Primary Care Emergency Centre (PCEC), but this has shifted to phone consultations during and following the pandemic.  For January to August 2023 at Scotland level, only around 37% of consultations were in a PCEC, and 46% were by telephone.
• As in previous years, the very young (<5 years), the elderly (75+ years) and people living in the most deprived areas had the highest OOH PC contact rates during 2023.

Background

From April 2014, data on activity at OOH PC services have been submitted by NHS Boards across Scotland and maintained by PHS in the national data warehouse. The OOH period for this publication includes evenings, weekends and Easter, Christmas and New Year public holidays. Between March 2020 and the end of March 2022 people calling NHS 24 with the main symptoms of COVID-19 were managed via a dedicated pathway. The data in this publication includes calls following this pathway in the out of hours period, as they were dealt with at NHS Board level by OOH PC services. Patient consultations are recorded as an attendance at Primary Care Emergency Centres (PCEC), Home Visits and/or PC OOH advice. An OOH patient contact/case can have more than one consultation type (e.g. telephone advice followed by home visit).

Further information

The date for the next release of this publication is to be confirmed.