Receptionists diverted appropriate calls to the triage nurse, while identifying any very urgent cases who could not wait in a queue.
Patients were phoned back by the nurse.
The triage nurse either offered telephone advice or identified the patient as needing to be seen face to face the same day.
A system to streamline management of patients into the appointment system after the triage was used.
Problems potentially requiring immediate GP attention following triage were diverted to the on-call GP for the day.
Patients identified as needing a GP or nurse appointment were given timed appointments there and then by the nurse. These were the slots previously left open each day for same-day problems.
Patients needing 'routine' appointments were diverted back to reception on the internal phone system.
The nurse had an hour of surgery time left unbooked to slot patients into in the morning. As well as allowing her to control her own workload, this gave her immediate feedback about the appropriateness of earlier triaging.