Total Triage: A New Era in Patient Care

What is Total Triage?

Total triage is a General Practice workflow where every patient contacting a practice first provides some informationon the reasons for contact and is triagedbefore making an appointment.

All routine patient requests will be triaged by one of our experienced GPs who will decide what the best course of action is. Where necessary, we might ask you to answer a few additional questions to help our doctor prioritise those patients who need more urgent care.

You could be given a face to face or telephone appointment; you could have a reply from the GP with self-care advice or you could be signposted to a more appropriate service.

We will have following types of appointments:

• Same day urgent face to face
• Same day urgent telephone
• GP 48 Hour Appointments 
• GP Routine 1 Week Appointments
• GP Follow up Appointments

The main purpose of the Total Triage model is to:

• enhance the quality of care our patients receive. 
• ensure they are given the most appropriate appointment or advice to meet their needs.
• communicate with patients in a timely way.
• Move away from first come first served approach to one based on patient needs.

How does it work?

All patients who ring the practice, complete e-consult or walk in to the practice will be assessed by reception team to do our best to get you to the right service in the first instance, with clinical triage being an option.

If you are unable to use or access the practice online form, then please contact the surgery in the usual way and we will complete the request for you.

After which the GP will review your request and you will either receive a call to be offered a same day appointment, receive a self-book link or you might receive a message with advice from the GP.

Please note that in order for the GP to triage your request in a timely manner it is very important to provide detailed and accurate information about your symptoms when you contact us in the first place. For example, if a patient has a cough, it would be much easier to triage the request with the following information: ‘I had a cough for 10 days. I have already used over the counter medicine, but it is not helping and in the last couple of days my cough has been worsening and it feels chestier. I also have a high temperature.’

If the information given is less detailed, such as ‘I had a cough for 10 days’, it makes it harder for the reception staff/GP to triage and we will need to request further information which could delay treatment.

The Total Triage service will be open Monday to Friday. During the weekend or bank holidays please continue to use the 111 service or call 999 for life threatening emergencies. Please note, there me be times when we may temporarily suspend the online triage form to help manage the demand. In these circumstances you will see the following:

• a message to advise that the Patient Triage is temporarily unavailable and information on when the link will be active again and how to contact the practice another way.
• a message prompting patient to use NHS 111 online, to find a local pharmacy or attend the Urgent Treatment Centre

How does this benefit you?

We know that change can be difficult sometimes, but we are confident that Total Triage will bring many benefits to our patients – for example:

• Total Triage has been shown to reduce waiting times and it enables us to attend to your medical needs more promptly.
• Using digital communication will mean that you can engage with us from the comfort of your home or workplace.
• Triage ensures that limited healthcare resources are allocated to patients who need them most urgently.
• Total Triage will address the increasing demand for appointments and reduce the frustration of having to call and be in a long queue at 8am.

If you have any questions or concerns our team is here to guide and support, you can contact the practice.

What if I have trouble using the new system? 

We hope to support patients and their families/carers to get used to the new way of contacting the practice and to become comfortable with this over time. 

We will, of course, provide additional support to those patients who are unable to use online resources.  

If you do not have on-line access, or experience other difficulties using digital technology, please speak to our patient services team about how we can help you in your usual way.

Do I have to share personal information with a receptionist if I ring/walk-in?

It is important you give us as much relevant information as possible so we can ensure your request is triaged properly.

We understand some issues can be sensitive and we can use a private room if needed.

Our Patient services team are trained in asking difficult questions, they have signed confidentiality documents and part of our team.  Their role is paramount to provide health services to our patients. 

Can I walk into the surgery to make an appointment?

We strongly discourage patients from walking in to make an appointment.  Primary care has never been an emergency service – if a patient needs immediate medical attention, you should ring 111 or go direct to A+E.

If a patient walks in, they will be treated the same as anyone sending an online consult or ringing the practice. The receptionist will ask you for details to care navigate you to the right service and will be add to the Triaging GP list to be assessed if right option.

It does NOT speed up your enquiry – we manage the requests based on a safety system.

Who else might I be asked to see?

Not every health problem needs a GP, you may be offered an appointment with the following:

Pharmacists – We have our own highly trained clinical pharmacists and technicians at the practice who manage all our blood pressure patient as well as complex medication issues.

Social prescribers – our team help patient where they may have a social problem or health problems linked with social situations. They can see patients and families at the practice or sometime at home.

Nurses – our experienced nurse team manage many chronic and acute conditions.

Community Pharmacies – a new program called ‘Pharmacy First’ has been set up to treat several minor conditions and they can prescribe antibiotics where appropriate.

Community Eye service – most eye conditions are managed by this team, and they link in with local optometrists.

Dentist – we are not able to manage any dental problems (even for emergencies) – if you don’t have your own dentist, please ring 111 for advice on accessing care.

Self-care – many conditions can be managed with advice and support.

Can I choose what time I come for an appointment?

For routine planned appointments, we will give as much flexibility as possible (subject to availability).

For urgent appointments, we expect patients to be flexible and will likely be asked to attend at any time between 8-6 subject to what we can offer.  We do NOT have flexibility on these.

Why can’t I send a request when you are shut?

Primary care remains a Monday to Friday, 8-6pm service.  There are other services available for urgent problems outside of this time.

We have to manage demand on the practice – our practice team work hard but also need to work within safe working conditions.

What happens if you are full?

We have carried out a lot of work looking at demand management and try to respond to predicted fluctuations in workflow. We have to remain safe – there has been a lot of concern about clinicians being overwhelmed by work stress and demand. This leads to sickness and reductions in service.

There will be times when the work demand will exceed capacity, in this situation, you will need to contact 111 directly or contact us the next working day.