Out of hours primary care services in Scotland
1 April 2014 to 10 January 2024

About this release

This release by Public Health Scotland (PHS) provides an update on Primary Care Out of Hours (PC OOH) service activity from 1 April 2014 to 10 January 2024. COVID-19 Hub/ Assessment centre activity is included from March 2020 to March 2022, as this was managed by the PC OOHs 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 December 2023. PC OOH data is missing for August and September 2022 due to a system outage.

Main points

• As in previous years, December 2023 was the busiest month of the year for PC OOH services, with around 108,000 consultations.
• Compared to December 2022, there was a small decrease of around 3,800 consultations at PC OOH services (3%) in December 2023. The number of unplanned A&E attendances in the out of hours periods has also decreased compared to December 2022 (down by 8%). 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.

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

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

• Over both the four-day holiday periods at Christmas and New Year 2023/2024, there were around 27,600 and 31,400 consultations respectively at PC OOH services, averaging at around 7,400 consultations per day. Over a typical weekend there are around 5,800 consultations per day.
• More recent trend data on comparison of A&E attendances to PC OOH consultations looks markedly different to older historical patterns (January 2017 to February 2020). This may reflect changes to patient pathways introduced by the Redesign of Urgent Care in December 2020, although the impacts of this are not yet fully understood.
• 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.
• 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 the calendar year 2023, at Scotland level, only around 38% of consultations were in a PCEC, and 44% were by telephone.

Background

From April 2014, data on activity at PC OOH 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. 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 on data on PC OOH service can be found on the metadata section of the web pages.

Further information

The date for the next release of this publication will be 5 March 2024.