In quotes: NHS 24 report reaction

The NHS 24 helpline service has been criticised by a sheriff over the deaths of two people in Aberdeenshire.

Sheriff James Tierney said the system had failed Shomi Miah and Steven Wiseman by not identifying their life-threatening conditions.

NHS 24 said it had since made major improvements to the service. The BBC Scotland news website brings together some of the reaction to the sheriff's findings.

Dr George Crooks, clinical director of NHS 24

"Over the past eighteen months, NHS 24 has made a number of changes to our processes, including advanced training to raise awareness of meningitis symptoms, regular algorithm training and the way in which third party calls and repeat calls are dealt with.

"Since these tragic deaths, NHS 24's service, particularly in terms of ability to access the service and the use of outbound calling has improved significantly.

"Improvements in the safety and effectiveness of the out of hours service have been made by NHS 24 and our partners in NHS Boards. Some of these have been in response to the independent review led by Owen Clarke, which reported in October 2005, and others arise from issues raised in these cases.

"We fully recognise that the circumstances of the two deaths will have caused great distress to the families involved. The most constructive outcome is that the NHS can learn from these events and continue to improve services for patients in the future."

Health Minister Andy Kerr

"NHS 24 is an integral part of the NHS. It performs a valuable service to thousands every month. But as with all organisations, it can improve. That's why we commissioned an independent review last year to identify improvements that could be made.

"It is reassuring to note that within his determination, the sheriff states that he is 'satisfied that the system of telephone triage by well qualified and properly trained nurse advisors using algorithms as a primary tool and working on the basis of erring on the side of caution is an efficient, well thought out and potentially safe method for the provision of out-of-hours service'.

"Health boards have already made changes, following on from last year's review, and in anticipation of some of the findings expected from the inquiry.

"I have asked the chairman of NHS 24 to report to me by the end of September 2006 on what steps the organisation has taken or is planning to take in response to all of the recommendations made by the sheriff."

Shona Robison MSP, Scottish National Party

"It is a tragedy for the families that this has happened so it is vital that changes are made to improve the service, the starting point for this is taking on-board the FAI's conclusions and recommendations.

"However, the SNP believe more fundamental changes are required including a complete restructuring of NHS 24. The service should be totally devolved to each Health Board as part of an integrated out-of-hours service involving both NHS 24 and out-of-hours GPs.

"A more locally delivered service will improve the quality of service for patients in Scotland, better able to meet the needs of the local community it serves."

Dr Nanette Milne MSP, Scottish Conservative Party

"NHS 24 was rolled out without proper piloting, despite promises to the contrary, and these tragic cases confirm there are still huge problems. There have been demands put on the service which it hasn't been able to meet.

"There is still a serious shortage of workers in NHS 24, and the body is still too centralised. That is not acceptable for such a flagship policy of this government.

"So far it has a very poor return considering the expense of running NHS 24 - £126m on over four years so far - and the low satisfaction ratings it has accrued. I know that work is being done to improve, but for NHS 24 to be a real success, we need more localised centres and an increase in staffing.

"The public need to be more aware of it too, so they can get the best out of this service."

A statement from Mr Wiseman's family

"The sheriff has gone on to identify serious defects in the system operated by NHS 24 which contributed to Mr Wiseman's death.

"His family hope that the findings will go some way to ensuring that no other family has to go through what they have endured."

Shomi Miah's brother, Khalis

"From the start we were saying that there is a problem with the system and if she had been taken into hospital at 6pm rather than 6am she could have been saved, and that's exactly what the report says."