The refer to A&E if in any doubt skill.
See BMJ this week for study comparing NHS direct to GP nurse triage
Objective To assess the relative effects on consultation workload and costs
of off-site triage by NHS Direct for patients requesting same day
appointments compared with usual on-site nurse telephone triage in general
practice.
Design Cluster randomised controlled trial.
Setting Three primary care sites in York, England.
Participants 4703 patients: 2452 with practice based triage, 2251 with NHS
Direct triage. All consecutive patients making requests for same day
appointments during study weeks were eligible for the trial.
Main outcome measures Type of consultation after request for same day
appointment (telephone, appointment, or visit); time taken for consultation;
service use during the month after same day contact; costs of same day,
follow up, and emergency care.
Results Patients in the NHS Direct group were less likely to have their call
resolved by a nurse and were more likely to have an appointment with a
general practitioner. Mean total time per patient in the NHS Direct group
was 7.62 minutes longer than in the practice based group. Costs were greater
in the NHS Direct group—£2.88 (£0.88 to £4.87) per patient triaged—as a
result of the difference between the groups in proportions of patients at
each final point contact after triage.
Conclusions External management of requests for same day appointments by
nurse telephone triage through NHS Direct is possible but comes at a higher
cost than practice nurse delivered triage in primary care. If NHS Direct
could achieve the same proportions of consultation types as practice based
triage, costs would be comparable.
http://bmj.bmjjournals.com/cgi/content/abstract/329/7469/774
Andy Webster
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of John PASKINS
Sent: 01 October 2004 08:30
To: [log in to unmask]
Subject: Re: Triage to GP out of hours service[Scanned]
There are plans for our OOH care to be provided by "differently skilled"
healthcare professionals.
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