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Major survey shows many practices did not triage before Covid-19

A third of GP practices did not offer triage before the Covid-19 crisis although all have now been urged to decide the order of treatment remotely since the outbreak. 

Thirty-four per cent of nurses said their practice did not offer a triage service in this year’s State of Primary Care survey, run by Nursing in Practice’s publisher Cogora, published today.

The survey of more than 3,000 practice nurses, ANPs and other primary care professionals was carried out during November and December last year.  

NHS England advised practices last month to rapidly take on a ‘total triage’ model during the Covid-19 pandemic.

However, the Royal College of Nursing professional lead for general practice nursing Marie Therese-Massey warned the increased demand for triage during the outbreak presents a ‘challenge’ for practice nurses without much experience in remote consultation.  

The findings also revealed a third of (34%) practices had run the triage service for over five years while one in 10 had provided it for under a year.  

Therese-Massey said: ‘Many practice nurses have stepped up to the mark and moved swiftly to implement the new ways of working.  

‘However, new skills are required to conduct remote consultations safely so the provision of appropriate learning packages and adequate supervision is essential in order to upskill the workforce in such a short time frame.’

She added: ‘I know that nurses in general practice will continue to maintain their high standards of care for patients throughout this crisis.’ 

Elia Monteiro, a practice nurse in London, said her workplace had moved to a ‘total triage system’ and she was undergoing telephone triage training.  

‘Nurses still have a high rate of face-to-face appointments due to the care provided but we triage the patients beforehand to ensure no household viral symptoms,’ she added.  

Claire Carmichael, a practice nurse in Portsmouth, said her admin and reception staff at her practice have ‘always’ run a triage service but nurses have also received training since the outbreak.  

She continued: ‘We only see urgent patients now. All other appointments like routine diabetes checks or annual asthma checks are all telephone consultations now.’ 

‘The admin staff usually carry out triage, but we are all mucking in at the minute including nurses and doctors,’ she added.  

NHS guidance has now stated that practice nurses can use commercial apps to reduce face-to-face time, including Skype, WhatsApp and Facetime.  

A total of 596 practice nurses and advanced nurse practitioners responded to survey questions on their practice’s triage service.