The impact of telephone triage in primary care on inequalities experienced by people with multiple morbidities: a quantitative evaluation

A patient living with more than one health condition may require a different approach to their care and might contact their GP practice more frequently. 

A telephone triage system is when you call your GP to make an appointment, and are told that a doctor or nurse will call you back. When they call, the doctor or nurse will listen to your problem, ask questions, and assess your condition. Depending on the telephone triage assessment an urgent or routine appointment will be set up, or the doctor or nurse will recommend a different kind of solution. There has been a gradual trend towards the use of telephone triage at GP practices, and this trend has increased since as a result of the Covid-19 pandemic.

Different groups of patients may have rather different experiences of interacting with their GP practice. A previous national study funded by the National Institute for Health Research (NIHR) found that the introduction of telephone triage leads, on average, to patients getting to speak to an appropriate doctor or nurse more quickly than when telephone triage is not used. This study builds on those findings by exploring whether this impact is the same for all groups of patients.    

The aim of the study is to evaluate whether it takes people with two or more long-term conditions longer than other groups of patients to see or speak to a doctor or nurse when their practice is using telephone triage. 

We will do this by analysing data from a routinely conducted national survey called the General Practice Patient Survey. We will also use more recent data from a different national survey called Understanding Society, collected since Covid-19, to put this analysis into a more recent context. We also want to examine if there are any other factors that affect the impact that telephone triage has on access to primary care, such as their gender, ethnicity, age, whether they live in more or less affluent, or rural or urban areas, and whether or not they are working.

This is a rapid evaluation that started in January 2021 and is expected to be completed and written up by late 2021. We intend to publish the findings through a number of different routes, including a final report and blog on the BRACE website, and in other ways suggested by members of the public who are advising the research team. 

• Dr Katie Saunders, Senior Research Associate, (Statistician) Cambridge Centre for Health Services Research. 
• Jon Sussex, Chief Economist, RAND corporation.
• Akis Gkousis, Analyst, RAND corporation.  

National Institute for Health Research Services and Delivery Research stream (NIHR HSDR) published report in Journals Library Impact of telephone triage on access to primary care for people living with multiple long-term health conditions: rapid evaluation Catherine Saunders, Evangelos Gkousis, July 2022 

The HSR UK Conference in July 2022 featured a recorded presentation of the evaluation Impact of telephone triage on access to primary care for people living with multiple long-term health conditions: rapid evaluation