Viewpoint: Why telephone triage might still be the right thing to do

Last week a big study in The Lancet made headline news: 'Telephone triage increases workload'.

The ESTEEM study took two years and over 40 practices to show that operating a telephone triage system increases workload in the 7,000 telephone consultations recorded.

The study itself is not a bad one; good method, good statistics, with results that are not exactly surprising and its conclusions are valid. You could quibble that looking at same-day service requests, excluding children and practices which have already adopted advanced access is narrowing the field, and that practices which take on such an initiative as part of a randomised trial might not really buy in to the changes required to operate clinical triage, but that would be, as I say, quibbling.

It is too rigorous a study to have real world application

The trouble is it is not news, other studies have reached similar conclusions in varying ways.

What made the study newsworthy is the government’s current push towards varying methods of access at a time when the profession is under-resourced and under pressure.

Put aside the political context for a moment and this study does have value. It provides a benchmark for follow up after a same-day service request, but other than that it is too rigorous a study to have real world application.

We should not take the study as saying telephone access will not work for some

My practice went live with a homegrown model of advanced access at the beginning of July. Already we have 3,000 real world telephone contacts with 25% of our 12,500 patient list, in just one month.

In two months we will have as much experience as the study-generated evidence in two years.

Granted, there are confounding factors galore in my practice; a committed team of medics with a large number of younger medics who are happy to do things differently, keen receptionists, a really low level of patient satisfaction with the old system, and a population which previously enjoyed a turn-up-and-wait appointment system until government diktat abolished it.

Of course I would not dream of suggesting that our way would work for everyone, that would be silly, but equally we should not take the ESTEEM study as saying that telephone access will not work for some.

We have never had one-size-fits-all general practice, despite contractual drivers, and in some places with certain features, it will be the right thing to do.

  • Dr Chris Mimnagh is a GP and co-director of clincial strategy at Liverpool Health Partners.

Photo: UNP

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

COVID-19 vaccination centre

BMA raises 'serious concerns' about GP workload and funding for autumn COVID boosters

The BMA has raised 'serious concerns' about the workload implications of this autumn's...


Monkeypox jabs will run out by next week, UKHSA says

The UK is likely to run out of smallpox vaccine stocks which it is using to protect...

NHS sign outside a building

Two Midlands hospitals end partnerships with Babylon

Two NHS trusts have prematurely severed their relationships with digital health provider,...

Person receiving a COVID-19 booster

JCVI sets out which vaccines to use for autumn COVID-19 boosters

The Joint Committee on Vaccinations and Immunisations (JCVI) has said that Moderna's...

The original Moderna COVID-19 vaccine

First COVID-19 vaccine to target Omicron variant approved for use in UK

The MHRA has approved an updated version of the Moderna vaccine that targets both...

Ballot box

Majority of GPs back taking industrial action in the coming year, poll suggests

The majority of GPs support taking industrial action in the coming 12 months to push...