References

Bunn F, Byrne G, Kendall S. Telephone consultation and triage: effects on health care use and patient satisfaction. Cochrane Database Syst Rev. 2004; (4) https://doi.org/10.1002/14651858.CD004180.pub2

Campbell JL, Fletcher E, Britten N Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster-randomised controlled trial and cost-consequence analysis. Lancet. 2014; 384:(9957)1859-1868

Centre for Workforce Intelligence. Think integration, think workforce: Three steps to workforce integration. 2013. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/507666/CfWI_Think_Integration.pdf (accessed 19 August 2020)

Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M (editors). Oxford: Oxford University Press;

Department of Health. The NHS Plan: A plan for investment, a plan for reform. 2000. https://webarchive.nationalarchives.gov.uk/20121102184216/ (accessed 19 August 2020)

Department of Health. Equity and Excellence: Liberating the NHS. 2010a. https://www.gov.uk/government/publications/liberating-the-nhs-white-paper (accessed 19 August 2020)

Department of Health. Advanced level nursing: a position statement. 2010b. https://www.gov.uk/government/publications/advanced-level-nursing-a-position-statement (accessed 19 August 2020)

Harding J. Qualitative data analysis from start to finish.Los Angeles: Sage Publications; 2013

Health Education England. Advanced Clinical Practice Definition. 2017. https://hee.nhs.uk/our-work/developing-our-workforce/advanced-clinical-practice/advanced-clinical-practice-definition (accessed 19 August 2020)

Huibers L, Keizer E, Giesen P Nurse telephone triage: good quality associated with appropriate decisions. Fam Pract. 2012; 29:(5)547-552 https://doi.org/10.1093/fampra/cms005

Lake R, Georgiou A, Li J The quality, safety and governance of telephone triage and advice services – an overview of evidence from systematic reviews. BMC Health Serv Res. 2017; 17:(1) https://doi.org/10.1186/s12913-017-2564-x

Marshall M, Howe A, Howsam G, Mulholland M, Leach J. COVID-19: a danger and an opportunity for the future of general practice. Br J Gen Pract. 2020; 70:(695)270-271

McCartney M. Medicine: before COVID-19, and after. Lancet. 2020; 395:(10232)1248-1249

McKenzie R, Williamson M. The league of extraordinary generalists: a qualitative study of professional identity and perceptions of role of GPs working on a national after hours helpline in Australia. BMC Health Serv Res. 2016; 16:(1) https://doi.org/10.1186/s12913-016-1387-5

Murdoch J, Barnes R, Pooler J The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences. Soc Sci Med. 2015a; 126:(126)36-47

Murdoch J, Varley A, Fletcher E Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial. BMC Fam Pract. 2015b; 16:(1) https://doi.org/10.1186/s12875-015-0263-4

NHS England. Report of the review of the quality and outcome framework in England. 2018. https://www.england.nhs.uk/publication/report-of-the-review-of-the-quality-and-outcomes-framework-in-england/ (accessed 19 August 2020)

North F, Richards DD, Bremseth KA Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support. BMC Med Inform Decis Mak. 2014; 14:(1) https://doi.org/10.1186/1472-6947-14-20

Nursing and Midwifery Council. Standards for pre-registration nursing practice. 2010. https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-pre-registration-nursing-education.pdf (accessed 19 August 2020)

O'Cathain A, Nicholl J, Sampson F Do different types of nurses give different triage decisions in NHS Direct? A mixed methods study. J Health Serv Res Policy. 2004; 9:(4)226-233 https://doi.org/10.1258/1355819042250221

Oldman C. Adapting practice during the pandemic. Pract Nurs. 2020; 31:(5) https://doi.org/10.12968/pnur.2020.31.5.220

Padgett D. Qualitative and mixed methods in public health.Los Angeles: Sage Publications; 2012

Pasini A, Rigon G, Vaona A. A cross-sectional study of the quality of telephone triage in a primary care out-of-hours service. J Telemed Telecare. 2015; 21:(2)68-72 https://doi.org/10.1177/1357633X14566573

Ross F, Smith P, Byng R Learning from people with long-term conditions: new insights for governance in primary healthcare. Health Soc Care Community. 2014; 22:(4)405-416 https://doi.org/10.1111/hsc.12097

Schober M, Affara F. Advanced Nursing Practice.Oxford: Blackwell Publishing; 2006

Smits M, Keizer E, Ram P, Giesen P. Development and testing of the KERNset: an instrument to assess the quality of telephone triage in out-of-hours primary care services. BMC Health Serv Res. 2017; 17:(1) https://doi.org/10.1186/s12913-017-2686-1

Turnbull J, Pope C, Martin D, Lattimer V. Management of out-of-hours calls by a general practice cooperative: a geographical analysis of telephone access and consultation. Fam Pract. 2011; 28:(6)677-682 https://doi.org/10.1093/fampra/cmr029

Wirihana L, Welch A, Williamson M Using Colaizzi's method of data analysis to explore the experiences of nurse academics teaching on satellite campuses. Nurse Res. 2018; 25:(4)30-34

Investigating staff perceptions and experiences of telephone triage in general practice

02 September 2020
13 min read
Volume 31 · Issue 9

Abstract

In this qualitative study, Alexandra Detheridge investigates the use of telephone triage in a general practice home visiting team

Background:

Telephone triage (TT) has historically been used in out of hours (OOH) provision for managing patients who require telephone advice or assessment face-to-face. It is increasingly being used in primary care to manage demand and advanced nurse practitioners are well placed to support this.

Aims:

To investigate staff perceptions and experiences of TT, barriers, role development, patient expectation and how care could be improved.

Methods:

Semi-structured interviews were completed with 8 staff (3 specialist nurses and 5 GPs) in a general practice home visiting team that provides care to 46 000 patients.

Findings:

TT use requires training and support for staff. While communication and patient engagement can be barriers, teamwork is a valuable means of improvement.

Conclusion:

TT enables the patient to see the correct clinician and can support care management in general practice.

Providing patients with improved access and excellent quality care is the aim of all NHS directives and the use of remote assessment is one way in which to develop practice in order to achieve this goal (Campbell et al, 2014). Telephone triage (TT) is a method employed by professionals to assess patients over the telephone to decide on the correct course of treatment for their ill-health, and this may involve self-care advice only, seeking a face-to-face GP appointment/attending a walk-in centre, or attending secondary care (independently or via an ambulance) (O'Cathain et al, 2004). Telephone assessment is not new and was primarily developed for use in out-of-hours (OOH) services across the world (Lake et al, 2017) and, in many cases, involves the use of clinical decision support software (CDSS) so that practitioners can standardise their triage and outcomes can be duplicated (North et al, 2014). Remote consultations using telephone/email and video assessments have increased exponentially in recent months following the impetus of managing care needs in general practice due to the COVID-19 outbreak (Marshall et al, 2020). Seemingly overnight, practices have changed the way their work is triaged and planned (Oldman, 2020).

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month