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Pharmacist-led telephone triage halves number of urgent same-day GP appointments

A pilot scheme has seen the number of same-day GP appointments reduce by half due to practice-based pharmacists triaging patients over the phone for urgent conditions. 

The initiative, piloted by St John's Way Medical Centre (SJW) in Islington, London, was implemented to tackle GP workload, improve staff morale and maintain continuity of care in return.

Under the service, patients needing urgent GP appointments were instead either dealt with on the phone or signposted to other services by a clinical pharmacist. 

As a result, the triage service saw a reduction in the need for face-to-face GP appointments by more than 50% within the first three months of launch.

In addition, it has saved 34 hours of GP time during the working week by 'replacing one of the on-call GPs with the pharmacist from Tuesday to Friday and by reducing the running time of the service by two hours each day'.

It follows praise for the new five-year settlement for community pharmacy, which introduced funding for new same-day consultations with pharmacists from October. The RCGP said it could help tackle GP pressures, but warned that it should not be seen as a 'silver bullet' to addressing the pressures in primary care. 

SJW practice manager Jack Johnson-Rose and clinical pharmacist Amira Shaikh said: 'Employing clinical pharmacists in GP practices means that GPs can focus their skills where they are most needed, for example on diagnosing and treating patients with more complex conditions. This helps GPs to manage the demands on their time. 

'Our aim was to reduce GP workload to a more manageable and sustainable level to improve staff morale, encourage effective teamwork, and maintain excellent clinical outcomes and continuity of care for patients. We propose to reduce the total number of non-essential GP encounters by 10% and to reduce the number of repeat prescription signings by 20%.'

They added: 'A three-month review of the project has shown positive results. We have managed to reduce the waiting time for patients to see a GP on the same day and have also reduced the total number of same day face-to-face contacts with a GP. Our data shows that 50% of patients who used the telephone triage system are either managed entirely on the phone without the need for a face-to-face GP appointment, or are signposted to an alternative appropriate service such as a community based health provider.

'We have saved 34 hours of GP time over the working week by replacing one of the on-call GPs with the clinical pharmacist from Tuesday to Friday and by reducing the running time of the service by two hours each day.'

However, recent research found that many GPs ignore pharmacists' advice because it is 'unlikely to benefit' patients

Official data has shown that four in 10 patients obtain a GP appointment booked on the same day, while 5% have to wait for a month to see their GP.

Readers' comments (6)

  • Crikey! The evidence suggests that GP triage deals with a 1/3 of calls but doesn’t help overall workload,
    What mystical skills do these pharmacy genies have that they can confidently deal with punters on the phone?
    Or are they ignorant of their unknowns, sowing the seeds for a future disaster?

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  • Or are they ignorant of their unknowns, sowing the seeds for a future disaster?

    It's the above. This is why you have your most experienced person triaging - not your least experienced.

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  • Unless your plan is to allow a worse cheaper service for the masses which, given the triple legal/regulatory jeopardy doctors face, is only possible by using new staff and judging them by their own training and peers, rather than by what they are replacing!

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  • Of course this is nonsense.

    However the question that needs asking is will the pharmacist keep medical records and have indemnity personally...or will all the risk be siphoned up to the supervising GP.

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  • you need to do it for a year then see what happens - once patients know it exists it will rack up massively and the waiting time will be with them instead, then see if they cope or not, those in the know will use it as a way to access earlier appointments with the GP. patients are not dumb

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  • Clearly pie-in-the sky.
    There is no way that 52% of calls can be adequately dealt with on the phone. I’ve had 20 years of experience doing ooh triaging as well as doing the same at my surgery. Audit after audit (in house) has demonstrated an effective triage rate of approximately 22%.
    Our registrars runaround a rate of 15% towards the end of their reg year.
    We have 3 clinical pharmacist of varying experience and I can quite categorically state that they would struggle to effectively manage 8%.
    Common sense suggests that this pilot is not reproducible on a sustained scale.

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