As the demand for UK primary care rises, it is estimated that 35% of patients in an average GP practice in England will request a same-day appointment. This inevitably increases the pressure on doctors and nurses to deliver good patient care. Earlier this year the Government pledged to improve GP access with an expanded role for remote consultations by telephone and Skype.
Many GP practices in England have subsequently adopted the GP or nurse triage telephone consultations to prioritise patients and filter out those with less serious needs. Following a major study involving more than 20,000 patients across 42 GP surgeries in England, it was found that approximately 12% of the daily GP consultations were conducted over the telephone.
Although it was hoped that this form of consultation would save money and/ or reduce the practice workload, the study revealed that the telephone triage delivered by a GP or nurse was associated with an increase in the number of primary care contacts in the 28 days after a patient's request for a same-day GP consultation, with similar costs to those of usual care.
The study therefore concluded that telephone triage offers no cost or time benefit and only serves to “redistribute” the workload or save up problems for later, making the system inefficient.
Naomi Holland, an associate in the Penningtons Manches' clinical negligence team, comments: “The lack of access to family doctors for patients has been an issue for some time and can be severely detrimental to patients with time-sensitive illnesses. The telephone triage service is undoubtedly beneficial as it can potentially prioritise patients where necessary. However, it is vital that these assessments are conducted appropriately and that patients are asked the right questions to gain a good understanding of their symptoms.
“Unfortunately, we have many cases where the telephone consultations were extremely brief and the GPs failed to get a proper understanding of their patient’s ailments. This can lead to misdiagnosis and, in some cases where prompt treatment is vital to the patient’s recovery, to serious consequences”.