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CAMHS won't see you now

Warning over non-medical practice staff triaging patients

More than half of all practice managers use some form of triage system, a new survey has revealed.

The Campden Health Survey of 1,195 GPs, nurses and practice managers - entitled ‘On the line: Access to Primary Care - found that 56% of practice managers polled had used some kind of telephone triage.

However, it also revealed that around half of the staff that triaged calls received no training in telephone triage, while 13% of respondents reported that receptionists with no medical background were involved in providing triage.

Almost all the respondents who used triage – 95% – said that it was either ‘moderately’ or ‘extremely’ successful.

Fiona Dalziel, co-lead of the General Practice Foundation at the RCGP, said: ‘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.’

The poll also showed that 44% of practices reported an increase in the number of patients that they were able to see and that practices showed a large variation in terms of the proportion of problems solved, with the lowest at 1% and the highest at around 60%.

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Readers' comments (16)

  • Our practice has changed to telephone triage which goes by the name of "Doctor First", but deny it is. The phone lines are still constantly engaged in the morning so if you need an emergency prescription you need to go to the Surgery, ask for a telephone consultation, go home, wait for the phone call, explain your symptoms, go back to the surgery, pick up your prescription and go home a happy and satisfied service user. I suppose it's too late to ask for a service called "Patient First"?

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  • @John Gessler For £2 per week providing a service that meets your needs would be very difficult. I think as a group patients expect more from their GP surgery than a phone company/ SKY/ Gym/ plummer etc and don't realise the small amount each individual patient contributes towards the practice. The NHS economy survives because GPs are able to manage their workload for a tiny fee per patient compared to any other part of the service. This is why there is not a queue of private companies looking to take over general practice and why those that do fail miserably.

    Next time try to get a prescription from a consultant by calling his secretary in the morning, try to get an appointment with your gym instructor the same morning after calling at 8am (without paying extra) and try to ask a plumber to repair a toilet for £2.

    Finally, once you have succeeded in all of those, try to organise a phone system where a doctor can take phone calls from any number of 2000 patients without making them wait, while seeing patients at the surgery and while making sure there is enough time to review results, do referrals, read letters from the hospital, provide medical reports, chase patients who fail to attend, meet government targets and handle members of staff. Your answer is keenly awaited.

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  • Goodness me receptionists have been pretending to be medical since time began! A dangerous practice and one I fear will continue unabated. I don't know what this "new" survey is about,has it revealed something we don't already know?

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  • @anonymous 9.07am - brilliant!

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  • Demand is so high for appointments that some sort of administrative triage is essential before patients get to our gp triage. I wish someone would design a really good administrative triage system that helps receptionists to point patients to the best person to help them; this might be a secretary, pharmacist or a dentist.

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  • What about deciding who gets referred as NHS England refers you back to the Manager who denies any connection with PAs using the Choose & Book designated by Commissioning ? I have found a number of surgeries allowing this to happen. .

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  • @ Anonymous 9:07

    I love the constant analogies on this site comparing plumbing to medicine as though they are in some way comparable. It's worth bearing in mind that the average plumber takes home £27K whereas the average GP takes home £104K.

    The NHS system works as it currently does because payment is made per patient on the list regardless of whether or not they use the service, so it's disingenuous to argue as though you are only getting £2.

    Ensuring that patients can be seen on the same day is a standard requirement in your job - so it's disingenuous to argue that this is some kind of "premium service" as you try to suggest.

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  • Why can't GP receptionists just have access to NHS 111 algorithms? I hear they're brilliant.

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  • Anonymous 11.23

    Why is disingenuous to claim we are getting £2 per week per patient to provide the GP service ? That works out as £104/per year/per patient which is actually at the high end of payments. Many GPs only get £80/patient.

    To suggest there are many patients on our books we do not see is wrong. The consultation rate is going up inexorably each year. This is why we are so stretched. This is why patients find it hard to be seen. We cannot physically see more patients because believe it or not we are only human beings and not members of a super race that does not need to eat or sleep or need to see our families.

    To train a GP takes ten years, a little different from training a plumber.

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  • To get to the bottom of the how much money per patient GPs really get it would be interesting to divide funding received per year by the number of appointments per year.

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