This site is intended for health professionals only

Must triage harder

Must triage harder

Everything is OK.

True, you might find it odd that we’ve been ordered to dig out the key to the waiting room doors and usher in all-comers despite there still being a pandemic on.

And, yes, it might seem strange that we’ve also been mandated to provide F2F consultations on demand, despite the official policy being the direct opposite of that until anti-GP columnists put us in the cross-hairs.

And, admittedly, you might be perplexed that we could have our appointments monitored to enforce adequate F2F provision, given that the modus operandi of the digital trailblazers long espoused by the likes of Mr Hancock is actually based on a remote-consulting future.

And, true, the insistence that e-consultations should be available out-of-hours seems both punitive and counter-contractual,  and  the rationale provided – that, otherwise, this would ‘reduce patient satisfaction’ – rings a bit hollow given that other things which are known to reduce patient satisfaction, like me taking a holiday or refusing to give antibiotics for colds, are not being centrally overridden, yet.

But, like I say, don’t worry. Because somehow, this rapidly-evolving, logic-inverting, terms-of-service-ignoring approach appears to work. I can explain this best by giving you the testimony of one of my own patients, reproduced here verbatim.

‘I felt a bit ill, so I tried ringing my surgery but I couldn’t get through, so I walked into reception and asked for a face-to-face appointment with my GP like they said in the papers, and after I filled out a form in the waiting room, the receptionist said I was being triaged to go home and send in an e-consultation, so I did that and the email reply said I was being signposted to a telephone appointment and when the doctor rang I said I wanted to be seen face-to-face, so he said come up to the surgery, so I did, and when I got there they checked my temperature and said I had a fever, so they told me to go home and ring 111 and when I did that, they advised me to ring my GP, but I couldn’t get through. Anyway, I feel better now.’

See? You might have been tempted to tell NHSE to SOP off. But actually it’s just a case of triaging harder. 

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at



Please note, only GPs are permitted to add comments to articles

James Cuthbertson 24 May, 2021 11:40 am

They want doors open so people can bully you and your staff in to giving appointments out. There is no reason for GP’s to not be able to screen whoever needs to come in to the building and wanting to demand an appointment is not a reason.

Patrufini Duffy 24 May, 2021 3:08 pm

The church closed, the police station disappeared, the schools adjusted and dentists closed up. They closed the walk-in centre, no visitors to the hospital and public health wiped to zero. You can’t refer out, because they’ve got backlog. And they’re remote anyway. Even the CCG is all at home.
Then there was YOU.
Like an old windy Western movie. Hanging around. Head on the bar table. Drooling from daytime somnolence. Almost apnoeic.
To hoover it all up. In case of trivial UK boredom and withdrawal from “their” GP. And now yes, they’re bored again. Not with advanced disease and failing organs. Just mind paranoia, laziness to self-care and disrespectful self-privilege. The summer sandal fungal nail, blocked armpit hair and palpitation lying bored in bed. Suddenly everyone wants a copper coil by next week, and everyone’s thyroid has crashed into a pandemic of fatigue and bloated constipation with all that Netflix popcorn. *I just had to F-F a rash (forced upon the practice), which has conveniently” disappeared”. Then had to explain it’s existence and pathophysiology. Without a photo. Because in all that selfie taking, you couldn’t be bothered to photo your life threatening issue. Of nothingness. What I have noticed now, is an increasingly lazy and blazeh public, who just cannot be bothered to tell you their history. “Tell me about your pain”…”err, well what do you wanna know?”. “When did it start?”…”err, I don’t know, maybe 17 years ago, could’ve been 5 actually?”. “Do you have a family history of cancer?”…”errr, I dunno, maybe, I can’t be sure, my mum has something, maybe my aunt too.” “Which pill do you take?…”err, the pink one, you can find out can’t you?”.
Triage harder, yes, like blood from a stone. Next, NHSE will mandate travel immunisations within 7 days. And a free ear syringe.

Dave Haddock 28 May, 2021 8:59 pm

Bought a pair of trainers in the local sport shop today, had a coffee in the local coffee shop, did some random browsing down he high street and bought a book in a charity shop. Went to the gym, and the dental hygienist. But because my local GP Practice still evades it’s responsibilities I had to pay to see a Specialist privately to get basic medical care.
Shameful behaviour by colleagues who are happy to be paid to provide a service but hide behind a fob-off system.

Patrufini Duffy 2 June, 2021 10:15 pm

DH – my non-intelligent observation.
You did 5 activities and paid for all 5. You liked that. You got an endorphin release. But hated the free one that didn’t meet your expectation. It didn’t have the glitz of the hygienist or urgency of the private specialist. Like getting a free Evening Standard, or free cookie. It’s never as good as the paid for Telegraph or Waitrose organic cake. If you give out free bread to 85 million people some will want pastries instead, same day. Your colleagues are paid for a service yes, that they cannot provide. That is completely correct. It cannot be mathematically provided. Because its open to 9 billion people. Free. That’s the whole point.