GPs urged to keep a third of appointments free

DoH-commissioned study backs enhanced training for receptionists to improve their triaging.

GPs can best manage urgent care by leaving a third of appointments free for same-day cases and training their receptionists in recognising urgent needs, according to a DoHcommissioned report.

Urgent Care in General Practice, which was co-authored by former GP Dr David Carson, looked at five PCT areas - Doncaster, Lambeth, Plymouth, Bolton and Norfolk.

It made 12 recommendations on how practices can best respond to urgent care.

One is that two-thirds of total appointments are booked in advance with the remaining third left for urgent same-day slots.

But GPC negotiator Dr Chaand Nagpaul said it was 'unhelpful to be prescriptive' about how practices handle urgent care.

'This needs to be seen as guidance. We must be wary of being prescriptive about the suggestions. It would be inappropriate for all practices to have a two thirds and one third split,' he said.

The report also said GPs should train receptionists to ensure they could recognise and respond to urgent cases.

It said the best practices had a framework for identifying urgent cases, training for reception teams and feedback and analysis.

The report found that almost all practices expected reception staff to recognise high profile emergency presentations, such as chest pain.

But response to a wider range of potentially urgent symptoms was 'worryingly variable' said the report.

When confronted with patients with epileptic seizures or babies who had become floppy, receptionists' responses varied from telling patients to dial 999, offering a later call-back from a doctor and passing them to a GP immediately.

The report said too few practices had identified an appropriate range of potentially urgent conditions.

'It's very hard to provide simplistic guidance on receptionists' training and level of awareness. We must recognise that they are not clinically trained and they must not respond to patients beyond their competence and knowledge,' said Dr Nagpaul.

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