Scottish Government Evaluation of Redesign of Urgent Care Pathway Reveals Positive Patient Experiences but Highlights Areas for Improvement
The Redesign of Urgent Care pathway for people in Scotland has helped to create positive experiences for patients using the NHS 24 111 service, according to an evaluation study published by the Scottish Government and conducted by Picker and Healthcare Priority Solutions. However, the study also identified long waiting times for NHS 24 111 calls to be answered and inconsistencies in adoption of the pathway across Scotland, suggesting room for further improvement.
The Redesign of Urgent Care pathway was introduced to improve public access to urgent and unscheduled care in non-life-threatening situations and to ensure that individuals receive the “Right Care in the Right Place at the Right Time”. This independent evaluation sought to assess the effectiveness of this system from both a patient and NHS staff perspective. The comprehensive review drew on feedback from patients who used or attempted to use the pathway, as well as NHS staff working across the urgent care system. Additionally, key metrics related to urgent care delivery were analysed to assess changes pre and post implementation of the RUC pathway.
Picker carried out research to gain insight from patients and staff, while Healthcare Priority Solutions conducted an Interrupted Time Series Analysis to assess changes to key urgent care delivery metrics by comparing performance pre and post-implementation of the Redesign of Urgent Care pathway. A Research Advisory Group provided advice throughout the project.
To understand patient and staff experiences, we undertook the following approaches:
- An online survey of 387 people who had attempted to access the RUC pathway by calling NHS 24 111 but ended the call before speaking to anyone (Discontinued Caller survey).
- A survey of 662 patients who had successfully accessed the RUC pathway via NHS 24 111 (Patient survey).
- Online focus groups with 21 NHS staff members working across the urgent care pathway.
Key Findings:
The evaluation highlights several important aspects of the redesign of urgent care pathway:
- Positive patient experience: For those who were able to access the pathway and engage with the NHS 24 111 service, patient experiences were largely favourable, with many reporting positive interactions with staff. Patients who received booked appointments at A&E or Minor Injury Units via the RUC pathway also noted shorter waiting times compared to those who attended without a pre-arranged appointment.
- Challenges in accessing services: While the overall experience was positive for many, the evaluation also identified that long wait times for NHS 24 111 calls to be answered) led some individuals to abandon their calls, revealing an area for further improvement in service responsiveness.
- Staff perspectives: NHS staff provided a range of feedback, with some expressing enthusiasm for the development of alternative care pathways and enhanced collaboration opportunities. However, there were also concerns about inconsistencies in how the RUC pathway was adopted across different Health Boards and challenges with implementation were highlighted by some.
The findings from this independent evaluation will inform future developments in the pathway to ensure better and more timely care for the public.
Esther Ainley, Senior Research Associate at Picker and integral to the project, said:
“We’re proud to have supported the Scottish Government in evaluating this important initiative. There is strong evidence that people who were able to access the new pathway had positive experiences of care. This is crucial for high-quality, person centred care.
One of the eight Picker Principles of Person Centred Care is ‘timely access to reliable healthcare advice.’ We hope and expect that the findings from this evaluation will help the Scottish Government and its partners identify further improvements in people’s care”.
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Notes to editors
- Picker is an international charity working across health and social care. Established in the US in 1987 and UK in 2000, our work is at the forefront of understanding the link between patient experience, person centred care, and clinical excellence. We believe in high quality person centred care for all, always.
- The full evaluation reports are now available for public access and can be found here:
- The Independent Evaluation of Redesign of Urgent Care Pathway was published on Wednesday 15th January 2025.
- Independent Evaluation of Redesign of Urgent Care Pathway was conducted by Picker and Healthcare Priority Solutions on behalf of the Scottish Government.
- For media enquiries, please contact the Marketing and Communications team at pressoffice@pickereurope.ac.uk, or phone: 01865 632 235.
