An innovative new access model using GPs to triage patients over the telephone before they are booked an appointment can dramatically increase capacity at surgeries and ease pressures on A&E, a new study suggests.
Practices offering patients brief GP telephone consultations promptly after initial contact saw their A&E use fall by an average of average of 20%, increases in through-flow of patients and falls in DNAs.
Most triaging conversations lasted less than three minutes, and only a third of patients then required a face-to-face appointment with a GP.
The method is being hailed by researchers as a potential breakthrough in the long-running drive to improve patient access, which led to flawed experiments with the Advanced Access model.
The research was carried out by Patient Access, a social enterprise set up by GPs. It claimed the findings – circulated across the health service by NHS Primary Care Commissioning – could save the NHS £200m in England alone if adopted nationwide.
Under the Patient Access method, patients telephone their practice, and GPs then call them back as soon as possible, with an emphasis on dealing with the problem the same day if the patient wishes.
The analysis examined data from 40 practices. Detailed evidence from one showed patients were waiting an average of two days to see a GP rather than seven, with waiting times to see the GP once at the surgery dropping from 17 to 12 minutes. Patient flow increased by 50%, while DNAs dropped by 60%.
Harry Longman, spokesperson for Patient Access, said the findings were ‘quite astonishing’: ‘Our aim is to enable everyone to understand this and take it on. It’s already been used all over the country in very different contexts – inner city, small towns, rural, commuter belt. It is definitely transferrable.’
Dr Simon Coupe, a GP in Christchurch, Dorset, one of the first to pioneer the GP triage system, said: ‘It’s probably reached a critical mass of practices involved. The effects have been staggering.’
‘Practices are sometimes afraid to change. Not everybody likes but they need to be brave and make the step.’
Professor Chris Salisbury, professor of primary healthcare at the University of Bristol and a GP in the city, carried out previous research on Advanced Access.
He said the findings ‘definitely have potential’, but shouldn’t be overstated: ‘It rings a bell with the way Advanced Access was brought in. It’s sold as doing these wonderful things but when look at it carefully you find it may do but not nearly as dramatically as was stated.’
‘Managers will jump on reductions in A&E because they’ll see potential for massive saving, but that might be misleading. It’s likely the practices doing it are better organised in different areas.’