Out of hours primary care services in Scotland
January 2017 to October 2024

About this release

This release by Public Health Scotland (PHS) provides new figures on Primary Care Out of Hours (PC OOH) services for the month of October 2024. Trend data includes COVID-19 Hub/ Assessment centre activity from March 2020 to March 2022, as this was managed by the PC OOH services in the out of hours period. Unplanned Accident and Emergency (A&E) attendances during the out of hours period are also presented up to October 2024. PC OOH data is missing for August - September 2022 due to a system outage.

Main points

• In October 2024, there were around 70,500 consultations at PC OOH services, a decrease (down by 12%) compared to October 2023. The number of unplanned A&E attendances in the out of hours periods has decreased slightly compared to October 2023 (down by 2%).

This Chart looks at monthly Primary Care OOH Cases and Consultations between January 2017 and September 2024. It also shows the number of unplanned A&E attendances in the out of hours period. During the summer A&E services have more attendances in the out of hours period, than OOH Primary Care cases possibly as a result of longer daylight hours and greater risk of injuries. During the winter months and months with public holidays there are more OOH Primary Care cases.

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Trends in Out of Hours Primary Care and A&E activity

• The relationship between A&E attendances and PC OOH activity changed during the pandemic and this persisted until early 2024. It showed a higher ratio of PC OOH consultations to unplanned A&E attendances compared to historical patterns (Jan 2017 – Feb 2020). This may have reflected changes to patient pathways introduced by the Redesign of Urgent Care in December 2020, although the impacts of this are not yet fully understood. More recent trend data appears similar to pre-pandemic patterns.
• The number of consultations per case rose during the COVID-19 pandemic which was driven by a higher use of telephone consultations. 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. Further information on cases and consultations can be found in the glossary.
• Pre pandemic, the majority (around 60%) of consultations took place face-to-face in a Primary Care Emergency Centre (PCEC) and around 20% were home visits. For the month October 2024, only 41% of consultations were in a PCEC, 10% were home visits and 39% were by telephone.

Background

From April 2014, data on activity at PC OOH services for each NHS Board in Scotland have been submitted to PHS by an external system supplier. PHS processes these extracts and maintains the national data warehouse. The OOH period for this publication includes 6pm - 8am, 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. Patient consultations are recorded as an attendance at Primary Care Emergency Centres (PCEC), Home Visits and/or PC OOH telephone/video advice.

The definition of a ‘case’ and how it should be recorded has changed over time and varies by board. The Scottish Government is continuing to work with the system supplier and boards to standardise recording.  We therefore recommend the use of figures on ‘consultations’, rather than ‘cases’, for meaningful trend analysis or comparisons between areas. 

The A&E attendances reported is based on unplanned data only and excludes new planned attendances introduced as part of the Redesign of Urgent care in 2020 as well as other types of planned attendances. In February 2025 new planned attendances will be included in the publication, to align with changes to PHS A&E statistics. Further information on data on PC OOH service can be found on the metadata section of the web pages.

Further information

The next release of this publication will be 04 February 2025. Please note there will be no publication on the 07 January 2025 due to the festive reporting schedule. Data covering the festive period will be published on the 4 February 2025.