NHS Direct versus general practice based triage for same day appointments in primary care: cluster randomised controlled trial

BMJ : British Medical Journal
David A RichardsJeremy Miles

Abstract

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. Cluster randomised controlled trial. Three primary care sites in York, England. 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. 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. 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 pounds sterling (0.88 pounds sterling to 4.87 pounds sterling) per patient triaged--as a result of the difference between the groups in proportions of patients at each final point contact after triage. Externa...Continue Reading

Citations

Aug 10, 2013·BMC Health Services Research·Rod LambertBrian Gaffney
Oct 16, 2008·BMC Health Services Research·Grzegorz MargasTomasz Tomasik
Oct 12, 2007·Australia and New Zealand Health Policy·David DuntLyle Gurrin
Mar 22, 2006·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Keith Hurst
Aug 30, 2011·Australian Health Review : a Publication of the Australian Hospital Association·Katherine E HardingSandra G Leggat
May 28, 2009·Journal of Telemedicine and Telecare·Frederick North, Prathibha Varkey
Jan 4, 2020·Journal of General Internal Medicine·Joel C BogganJennifer M Gierisch
Dec 16, 2020·Research in Nursing & Health·Allison A LewinskiJennifer M Gierisch
Oct 8, 2021·Journal of Telemedicine and Telecare·Keshia R De GuzmanAnthony C Smith

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