Patients who receive telephone consultations from their GP or a nurse are more likely to need care in the month after their phone call than those who see doctors face to face, a new study suggests.
Experts found that people who requested a same day appointment but were instead offered telephone triage from a GP were 33 per cent more likely to seek help within 28 days after the phone call.
As demand for appointments to see family doctors has soared, telephone triage has become increasingly popular in general practice, the authors said.
This means patients are called by a doctor or nurse who can either deal with the problem over the phone, or decide as and when a patient needs to be seen.
But researchers found that such consultations may not be the most efficient use of a doctor’s time.
Their study, published in The Lancet, found that they did not reduce workload but just saw it “redistributed” from face to face consultations to telephone consultations.
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Forty-two practices took part in the study and offered their patients usual care, telephone triage with a GP or a nurse led computer supported consultation.
Almost 21,000 patients who were seeking same day appointments were included in the study.
The researchers, led by experts from the University of Exeter, found that when compared with usual care, GP triage was associated with patients being 33 per cent more likely to need care in the 28 days following the phone call compared with standard care.
And nurse triage was associated with a 48 per cent increase, they said.
They also found that GP triage was associated with a 38 per cent increased rate of workload for family doctors, the rate of face-to-face contacts reduced by 39 per cent.
Meanwhile, the costs of care were similar across all methods studied, they found.
“Up to now it has been widely thought that introducing a triage system might be an efficient way of providing same day access to healthcare advice,” said lead author John Campbell, of the University of Exeter medical school.
“However, our study suggests that introducing triage may not represent the most efficient use of doctor or nurse time. Patients who receive over the phone support are more likely to seek follow up advice, meaning that the workload is only redistributed, whilst the costs are the same.
“Practices thinking about introducing triage might benefit from looking at our findings carefully, and considering whether introducing triage is really likely to be of benefit to their patients, or to the primary care practice team. Healthcare managers should consider the implications across the whole system of introducing triage on a wider scale, especially given the staffing constraints and challenges faced by the NHS.”