The future of NHS 24, Scotland's troubled nurse-led helpline, again looked in doubt last week after a judge concluded it was implicated in the deaths of two patients.

The future of NHS 24, Scotland's troubled nurse-led helpline, again looked in doubt last week after a judge concluded it was implicated in the deaths of two patients.

Shomi Moshina, 17, and Steven Wiseman, 30, both from Aberdeenshire, could have lived had staff at NHS 24 'erred on the side of caution', according to Sheriff James Tierney.

Nurses advised both patients, who had separately complained of flu-like symptoms, to take pain-killers, but both died; Ms Moshina of meningitis and Mr Wiseman of serious complications.

Health minister Andy Kerr has given NHS 24's chair until the end of September to explain how the organisation will respond to the sheriff's criticisms and recommendations.

Sheriff Tierney, who conducted a fatal accident inquiry (Scotland's equivalent of an inquest) into the two deaths, cited poor training, poor questioning and a desire to avoid GP visits. He said it was 'tragically clear' that the system had failed the two patients.

His report is the latest blow to the organisation, which has already made major changes as a result of a Scottish Executive-commissioned inquiry, which reported last September.

The executive's report noted that NHS 24, which is now the gateway to out-of-hours services across Scotland, had problems finding staff and could not meet demand.

Last week's report provoked calls for more radical action, however.Scottish National Party health spokeswoman Shona Robison said NHS 24 should be radically restructured and its functions 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,' she said.

Mr Kerr said NHS 24 had already made changes following the previous imquiry, but added: 'I have asked the chair 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.'