The report concludes: ‘NHS boards should be given the responsibility for devising - and should be enabled to deliver - specific, sustainable, and often innovative arrangements whereby out-of-hours services meet the needs of individual communities. This should be delivered in consultation with those communities.'

It adds: ‘The committee would, therefore, welcome a drive, across the country, towards finding solutions that deliver top quality services in challenging situations without depending on expensive methods such as buying in GP time at an hourly, ad-hoc rate.'

RCN Scotland welcomed the emphasis on ‘innovative' approaches.

Theresa Fyffe, RCN Scotland director, said: ‘I am pleased that today's report appears to recognise that it is not access to a GP in the out-of-hours period that should be important, but it is speedy access to an appropriately skilled healthcare professional that health boards should be striving for.

‘In some rural areas, as part of a mix of services, highly qualified and skilled nurse practitioners provide expert care and treatment to patients alongside other healthcare professionals, supported by GPs and also by telemedicine.'

Dr Andrew Buist, deputy chairman of GPC Scotland, said: 'We believe that out-of-hours provision should be better integrated and we would agree that the public are confused about who to contact for out-of-hours services, and that this should be addressed.'

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