The Total Triage model has become more significant in general practice, particularly in light of the recent directives from NHS England to GP appointments. Patients can no longer be asked to “call back later” when asking for an appointment, as part of a new GP contract.
What is NHS’s Total Triage?
The Total Triage model in General Practice is a way of managing patient appointments that prioritises safety, efficiency, and patient satisfaction. It involves a comprehensive system for assessing patients’ needs, determining the most appropriate type of appointment, and directing them to the appropriate clinician or service.
Under the Total Triage model, every patient contacting the practice is first triaged by a trained healthcare professional before making an appointment. Patients are asked to complete an online request form through the practice website. The online request is automatically directed to appropriate person in the practise who can help the patient as soon as possible.
The online form consists of a brief questionnaire regarding the symptoms and reasons for requesting the appointment. Depending on the response submitted, the patient may be offered a same-day appointment with a clinician, a telephone or video consultation, or advice and self-care instructions.
The aim of total triage is to ensure that patients receive the most appropriate care in a timely manner, without unnecessary delays or inconvenience. By triaging patients in this way, general practices can manage demand more effectively, reduce waiting times, and improve patient satisfaction. It also helps to ensure that patients with urgent or complex needs are seen by the most appropriate clinician, which can improve the quality of care and patient outcomes.
Benefits of Total Triage
There may be potential for these new ways of working to facilitate personalised care, to lead to greater satisfaction for patients with their care, and even perhaps a more efficient system overall.
Not only will this better meet patient needs, it will also reduce time wasted for clinicians unable to get through to patients and having to call back. Patients can be seen based on their clinical need, not who arrived at the practice first. Over 70% of requests to practices can be dealt with remotely without the patient needing to come into the practice.
Clinicians can review the online request in 2-3 minutes as opposed to a 10-minute face to face appointment. Reduced number of inbound and outbound telephone calls.
Why Total Triage is not offered by many practices?
After speaking to many practice managers and GP partners, we have discovered that many GP practices are still using the traditional way of requiring patients to call the practice for appointments and appointments are offered on first come first basis rather than any meaningful triage.
GP practices have shared their concern and apprehensions regarding making it “too easy” for patients to send in their appointment requests. A high volume of online requests will exacerbate the pressures on GP practices. Research also suggests that digital first triage approaches (including online, telephone and video) are likely to increase general practice workload.
Total Triage may end up presenting a barrier to care because an online form is overly complicated, or ends up diverting patients elsewhere such as A&E unnecessarily.
There are also concerns that some systems do not have sufficient ‘red-flag’ systems in place, which would enable the appropriate flagging and recording of serious or urgent symptoms promptly, particularly to out of hours services.
Some patients, including those who don’t have good IT access or digital literacy, will always need to be able get an appointment through traditional routes such as over the telephone or in person.
How v-Consult can help practices?
An intelligent disruptive v-Consult app is an excellent tool to support the total triage model in General Practice. Here are a few ways in which our v-Consult app can help with total triaging reducing some of the current apprehensions.
vConsult is available on web as well as on NHS App making it more accessible. NHS App is now used by over 30 million users in United Kingdom.
vConsult has been designed by GPs and for GPs. The online form is simple but also captures enough information to make the information meaningful and triagable. Intelligence is programmed to disallow one worded response to the questions.
Simple measures are put into place to enable patients to easily indicate options of time periods where they can / cannot be contacted.
Concerning symptoms reported by a patient through digital screening are recorded and picked up promptly, and signposted to enable a rapid response, including linking to out of hours services. Responsible on-call GP is immediately notified when any high risk symptom is submitted through vConsult.
vConsult supports mechanisms for clinicians to easily and swiftly report any issues with digital triaging software. This enables clinicians to flag issues in real-time to an independent clinician-led board, where there may be a patient safety concern.
vConsult is designed to facilitate relationship-based care, including enabling a patient to make an informed decision about seeing the same clinician where patients feel they would benefit, and to express their preference about this.
vConsult also includes NHS curated self-care advice and guidance on managing common health conditions.
Embracing Total Triage
Additional support is provided to practices, including time and resources, to evaluate, refine and effectively embed vConsult for remote consulting and triage.
To ensure that all patients can access care through traditional routes when they need to, as well as to support improving digital literacy and digital access where appropriate, a streamlined process could be put in place to identify patients without good access to the digital technologies required or/ and lower levels of digital literacy.
Integration into GP IT systems including TPP and EMIS can help reduce manual entry of online requests into the patient records. vConsult provides bespoke integration into SystmOne and EMIS Web ensuring accuracy and speed in availability of online requests into the patient records.
By supporting the total triage model in these ways, our virtual consultation app (v-Consult) can help general practices to manage patient demand more effectively, reduce waiting times, and improve patient satisfaction. It can also support the delivery of safe, high-quality healthcare that is responsive to patients’ needs.
If you’re interested in learning more about how we can help Capri Healthcare, let’s schedule a brief conversation. You can use this link to book a convenient time.