Study amends NHS telephone treatment policy

A study led by the University of Exeter Medical School has concluded that the NHS strategy to shift primary care to telephone consultations “does not save money or reduce practice workload.”

The study found that patients who receive assessments via telephone, known as ‘telephone triage’, following their request for a same-day consultation with a GP are more likely to require further support or advice when compared to patients who see a doctor in person.

Telephone triage has becoming increasingly popular in general practice as a response to managing patient care. Overall, the ESTEEM study – one of the first robust investigations in this field – concluded that telephone triage by a doctor or a nurse only results in a redistribution of practice workload, not a reduction. It also discovered that telephone triage is no more expensive or cheaper than care provided via traditional face-to-face appointments.

Lead author Professor John Campbell, of the University of Exeter Medical School, said: “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. 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."

Demand for primary care is rising with an estimated increase in workload of around 62 per cent between 1995 and 2008. Already around 12 per cent of GP consultations are conducted on the telephone, a quadrupling since 1995.

The study also involved collaborators from the University of Oxford, the University of East Anglia, the University of Bristol, and the University of Warwick. It is the first large-scale study in the world to identify the potential value and implications of introducing GP-led or nurse-led triage of patients requesting same-day consultations, putting Exeter’s university at the forefront of creating national healthcare policy.