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Increasing workload boosts use of telephone triage in GP practices

But more than 10% of provision involves non-medically trained staff, poll shows

Caroline White

Tuesday, 03 September 2013

Telephone triage is increasingly being used in general practice to boost access to healthcare, amid rising workload, a survey of more than 1000 UK primary care health professionals indicates.

Half of the practices polled don’t provide training in telephone triage and more than 10% of those involved have no medical training, the findings show.

The survey, published by Campden Health, and carried out in July and August of this year, draws on the responses of practice managers (37%), nurses (42%), GPs (7%), and others (14%) who were quizzed about patient access and practice activity.

Over half of respondents (54%) said they worked at a practice which used some form of telephone triage. More than one in four (28%) practices triaged up to 10% of patients, and 9% triaged all their patients.

Three out of four (74%) said the service boosted efficiency, and nearly all (95%) respondents rated it as either ‘moderately’ or ‘extremely’ successful.

Patients were somewhat less enthusiastic, however, with half of respondents saying that over half of their triaged patients responded positively to it.

The bulk of telephone triage was carried out by GPs (83%) and nurses (35%). But more than one in 10 (14%) practices said receptionists or practice managers without a medical background were involved in providing triage, and that many of them did so without the aid of training or a clinician’s help.

Fiona Dalziel, co-lead of the General Practice Foundation at the Royal College of General Practitioners commented: "Anecdotally, receptionists are quite good at differentiating urgent from non-urgent situations. However, they have had no medical training and are frequently not working to a decision-making protocol and so that leads to increased patient risk.”

Furthermore, the poll results suggests the need for a more standardised approach to telephone triage as only 44% of practices said the service had enabled them to see more patients, and the proportion of problems resolved as a result ranged from 1% to over 60%.

The survey also found that GPs were working harder, with most respondents (84%) attributing this to increased workload, 20% to more patients, and 26% to funding issues.

A substantial proportion of the general practice workload was accounted for by patients who did not need to be seen, with over half of the healthcare professionals polled saying they see between six and 10 such patients every day. Around one in 10 practices said they saw more than 20 of these patients every day.

This could be costing the NHS up to £836.5 million a year for all the UK's 63,854 GPs, the pollsters say.

Joe McGilligan, GP partner at Greystone House Medical Practice and chairman of East Surrey Clinical Commissioning Group, said: "We have a cradle to grave responsibility, so obviously people feel we are the point of call for all their woes even if it is not what we are trained for nor adequately resourced in expertise or knowledge.”

He added: "I never see patients as wasting my time, just misdirected in what I can offer. Having social workers in the practice as well as health visitors could go a long way to improving everyone’s perception of a good job done.”

Survey: On the line: Access to Primary Care in the UK

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