Investigating the public's use of Scotland's primary care telephone advice service (NHS 24): a population-based cross-sectional study.

Background: There has been no comprehensive examination of the public's understanding of, and attitudes towards, NHS 24.

Aim: To investigate the public's use of NHS 24 and explore their understanding of, and beliefs about, the service.

Design And Setting: Population-based cross-sectional study of adults in Scotland.

Method: Quantitative data were collected by self-completion postal questionnaire and qualitative data by follow-up telephone interviews.

Results: A corrected response rate of 34.1% (n = 1190) was obtained. More than half (51.0%, n = 601) of responders had used NHS 24. Callers were more likely to be female, have at least one child, and be aged 25-34 years. Most calls (92.4%, n = 549) were made out of hours, and 54.6% (n = 327) were made on behalf of someone else. The main reason for calling was to get advice about a new symptom (69.0%, n = 414). A total of 38.6% (n = 219) of users contacted another health professional following their call, mostly on NHS 24 advice (71.7%, n = 157). Over 80.0% (n = 449) of callers were satisfied with the service and 93.9% (n = 539) would use it again.Only 8.4% (n = 78) of responders had used the NHS 24 website and 4.6% (n = 53) the NHS inform service. The main reasons for non-use were not needing the service, a preference to see their own GP, and not knowing the telephone number. NHS 24 was mainly viewed as an out-of-hours alternative to the GP. It was not considered an appropriate service for minor symptoms. The main facilitator to use was convenience, whereas the main barrier to use was not knowing how and when to use the service.

Conclusion: Although most people who used NHS 24 were satisfied, others were unclear about how and when to use the service. Further education about the full range of services that NHS 24 offers should be considered.