A geographical case study of two primary care nursing triage systems in Wales

Background A General Practice workforce crisis is emerging (Dayan, Arora, Rosen & Curry, 2014), with fewer medical professionals training as General Practitioners (GPs) and more GPs working part-time and planning to retire early. Optimising the workforce, by changing the way that primary care services are run, could help to resolve the imbalance between GP supply and demand (Osborn & Thompson, 2014). Use of the nurse triage system in primary care means that only patients who need to see a doctor are seen by the GP, whilst the rest of the patients have their needs met accordingly by other healthcare professionals or services. Aim To present a geographical case study of two nurse triage systems delivered in primary care in a GP cluster in Wales. Methodology Reports were created to identify the number of triage appointments, the type of triage appointments, clinical outcomes of the triage encounter, patient age and sex. Findings Less than half (45.47%) of triage encounters were referred on for contact with the GP, resulting in avoidance of 10,940 GP appointments over the pilot period. The remainder of patients were offered advice, a prescription or sick note, an appointment with a nurse, a referral for further care or an immediate referral to emergency services. The Total Nurse Triage system was also effective in reducing GP routine appointment waiting times and identifying clinical priorities to be seen urgently. Impact This paper illustrates how nurse triage for both on the day appointments and routine appointments can be used to improve patient clinical outcomes, relieve pressure on GPs and improve patient experience.