Appointment system upgrade

Overview

We wish to share some very exciting news about a significant change to our appointment system that will improve the way our surgery delivers care to all our patients.

GP surgeries across UK are moving to a ‘Modern General Practice’ model to make access to care and treatment easier for patients and help improve patient satisfaction. This is a national NHS project, and all surgeries must adopt the system eventually.

From 1 September 2025, we will start total triage via Patchs.

What is total triage?

Total triage is a general practice workflow where every patient contacting the surgery provides some information on the reasons for contact and is triaged before an appointment is made.

All patient requests will be triaged by one of our experienced GPs who will decide what the best course of action is. Where necessary, we might ask you to answer a few additional questions to help our doctor prioritise those patients who need more urgent care.

You could be given a face-to-face or telephone appointment, a reply from the GP with self-care advice, or you could be signposted to a more appropriate service.

We will have following types of appointments:

• Same-day GP triage
• Same-day face-to-face or telephone calls
  For emergencies.
• Within 7 days
  For a follow-up with a healthcare professional if not urgent. You may receive a self-book link to book your appointment or receive a phone call from our admin team if a GP feels it is necessary.
• More than 7 days
  For routine planned appointments. You may receive a self-book link to book your appointment or receive a phone call from our admin team.
• Annual review or planned follow-up requested by GP
  Requests made for nurse appointments, blood clinics or pharmacists will be requested via Patchs and admin will contact you with an appointment or send you a self-book link.

The main purpose of the total triage model is to:

• enhance the quality of care our patients receive
• ensure they are given the most appropriate appointment or advice to meet their needs
• communicate with patients in a timely way
• move away from first come first served approach to one based on patient needs

How does it work?

All patients will complete a Patchs form online which can be accessed via our website or the NHS App. If you do not have a smartphone or computer, you can telephone or visit the surgery and our reception team will complete a Patchs form on your behalf.

Once your Patchs form has been submitted, the GP will review your request and you will either receive a call to be offered a same-day appointment, receive a self-booking link, or you may receive a message with advice from the GP.

Please note that in order for the GP to triage your request in a timely manner, it is very important to provide detailed and accurate information about your symptoms when you initially contact us. For example, if a patient has a cough, it would be much easier to triage the request with the following information:

“I’ve had a cough for 10 days. I have already used over the counter medicine, but it is not helping and in the last couple of days my cough has been worsening and it feels chestier. I also have a high temperature.”

If the information given is less detailed, such as “I’ve had a cough for 10 days,” it makes it harder for the reception staff and GP to triage and we may need to request further information which could delay treatment.

The total triage service will be open Monday to Friday. During the weekend or bank holidays, please continue to use the 111 service or call 999 for life-threatening emergencies. Please note there may be times when we may temporarily suspend the online triage form to help manage the demand. In these circumstances, you may see:

• a message to advise that the patient triage is temporarily unavailable, including information on when the service will be active again and how to contact the surgery another way
• a message prompting you to use the NHS 111 service, to find a local pharmacy, or to attend an urgent treatment centre

How does this benefit you?

We know that change can be difficult sometimes, but we are confident that total triage will bring many benefits to our patients. For example:

• Total triage has been shown to reduce waiting times and it enables us to attend to your medical needs more promptly.
• Using digital communication will mean that you can engage with us from the comfort of your home or workplace.
• Triage ensures that limited healthcare resources are allocated to patients who need them most urgently.
• Total triage will address the increasing demand for appointments and reduce the frustration of having to call and be in a long queue at 8am.

If you have any questions or concerns our team is here to guide and support, you can contact the surgery.

Why is the surgery changing its appointment system?

The staff at Grove Road Surgery, along with NHS England, have acknowledged the increasing demand for appointments and our capacity being unable to meet this demand. NHS England have published a paper outlining their similar concerns.

There are not enough GP appointments nationally to meet increased patient demand so we are needing to ensure only those who need to see a GP will get an appointment. What a patient may want is not the same as what they need. Many conditions can be managed by non-GP clinicians – this includes physiotherapists, pharmacists, mental health workers, social prescribers, and other members of the team. The NHS system is complex to navigate, and we recognise patients need help with this.

Total triage has been designed to ensure that patients who most need an appointment are able to get one, and to facilitate equality of access to care.

We understand how frustrating it can be for patients to wait in phone queues to get an appointment. We have also noticed that many patients are booking appointments that do not necessarily require one, and we are concerned that those who need to be seen are not getting seen at the right time.

NHS England has stated that there is good evidence that clinician triage and modern online tools make it easier to manage patient requests and involve the wider team, with higher patient satisfaction rates than with the more traditional model.

To address this issue, we are introducing a total triage model of care. This means that anyone requesting an appointment or advice will have their request triaged. Our online consultation forms provide us with key information about your problem, so that we can arrange an appointment at the right time with the right person if needed.

How do I access the surgery services?

You can continue to access the surgery services in your usual way, but we do know that some of you have to wait for several minutes on the phone or in front of the reception queue until you can get through when it’s busy. However, the surgery would like to encourage everyone to start using Patchs via our website or the NHS App to send your clinical requests through.

How will the surgery respond?

All Patchs forms will be received by the duty doctor of the day and will try our best to get you to the right service in the first instance, including local services and clinical triage.

We can arrange an appointment with one of our allied health professionals, such as our nursing team, clinical pharmacists, social prescribers, first contact musculoskeletal specialists, etc.

If an appointment is necessary, you will be sent an electronic link to make either a priority or routine GP appointment (depending upon the GP assessment of the urgency of your condition), or we will telephone you to organise the appointment.

Please be reassured that those with problems requiring a more urgent response will be identified by GPs and contacted urgently if a same-day appointment is needed.

In some cases, we will be able to arrange necessary tests/investigations prior to your attendance, to maximise the value of your appointment.

You may also be directed to a community pharmacy or given advice via text message or email.

What if I have trouble using the new system?

We hope to support patients and their families/carers to get used to the new way of contacting the surgery and to become comfortable with this over time. We will, of course, provide additional support to those patients who are unable to use online services.

If you do not have online access or experience other difficulties using digital technology, please speak to our patient services team about how we can help you in your usual way.

Do I have to share personal information with a receptionist if I ring/walk-in?

It is important you give us as much relevant information as possible so we can ensure your request is triaged properly. We understand some issues can be sensitive and you can use a private room if needed.

Our patient services team are trained in asking difficult questions. They have signed confidentiality documents and part of our team. Their role is paramount to provide health services to our patients.

Can I walk into the surgery to make an appointment?

We strongly discourage patients from walking in to make an appointment. Primary care has never been an emergency service – if a patient needs urgent medical attention, they should call the NHS 111 service or go direct to A&E if it’s an emergency.

If a patient walks in, they will be treated the same as anyone sending an online consult or ringing the surgery. The receptionist will ask you for details to care navigate you to the right service and will be added to the triage list to be assessed.

It does not speed up your enquiry. We manage all requests based on a safety system.

Do all appointments have to be booked this way?

We would like to do all appointment requests this way but often appointments for our nursing team can be managed via telephone. This will be particularly relevant for chronic disease annual reviews, blood tests, wound management, etc.

Why can’t I just book an appointment like I used to?

Nationally, GP capacity can no longer meet the demand and so we must put systems in place to ensure our patient gets the most appropriate safe care. Healthcare is evolving, and we need to embrace this.

Isn’t this ageist?

No. The majority of our more senior patients have access to the internet or smartphones and are quite capable of using the simple online system.

We are planning to use our reception team at the surgery to support anyone who needs a bit of extra help in the early days.

What about vulnerable patients or those with special needs?

We work hard to identify our patients who may need extra help and can flag this on medical records ensuring the team are aware of any additional requirements. If someone is struggling to navigate the system, we will support them in any way we can.

What types of GP appointments are there?

We have several types of appointments which we can triage patients for. These include the following:

• Same-day clinical GP triage
• Urgent
  These tend to be ‘on the day’ telephone or face-to-face. These are shorter appointments to manage only one acute problem.
• Routine
  These are for non-urgent problems. Waiting times vary but can be approximately 2 to 5 weeks, depending on individual GP availability. These are usually for planned annual reviews.
• Patient-initiated follow-ups
  The GP will send you a booking link for telephone or face-to-face follow-ups. The link will encourage patients to attend and use the appointments if they still require to. This should reduce the number of missed appointments.
• Telephone
  Many things can be managed conveniently and safely over the phone. We will usually give a two-hour window for this call.

Who else might I be asked to see?

Not every health problem needs a GP. Over the last 5 years, we have significantly expanded our team. Health problems might require the following:

• Pharmacists
  We have our own highly trained clinical pharmacists and technicians at the surgery who manage all our blood pressure patients as well as complex medication issues.
• First contact physiotherapists
  They see all musculoskeletal problems and come up with a plan after assessing the problem. This may include further tests or referrals, and they link directly with the hospital.
• Social prescribers
  They help patients where they may have a social problem or health problems linked with social situations. They can see patients and families at the surgery or sometimes at home.
• Nurses
  Our experienced nursing team manage many chronic and acute conditions.
• Community pharmacies
  A new program called Pharmacy First has been set up to treat several minor conditions and they can prescribe antibiotics where appropriate.
• Community eye service
  Most eye conditions are managed by this team, and they link in with local optometrists.
• Dentists
  We are not able to manage any dental problems, even in emergencies. If you don’t have your own dentist, please ring 111 for advice on accessing care.
• Self-care
  Many conditions can be managed with advice and support.

Can I choose what time I come for an appointment?

For routine planned appointments, we will give as much flexibility as possible (subject to availability).

For urgent appointments, we expect patients to be flexible and will likely be asked to attend at any time between 8am to 6pm, subject to what we can offer. We do not have flexibility on these.

For urgent health problems, employers are legally expected to allow employees to attend these, including at short notice.

Why can’t I send a request when you are shut?

Primary care remains a Monday to Friday, 8am to 6:30pm service. There are other services available for urgent problems outside of this time. We have to manage demand on the surgery. Our surgery team work hard but also need to work within safe working conditions.

What happens if you are full?

We have carried out a lot of work looking at demand management and try to respond to predicted fluctuations in workflow. We have to remain safe – there has been a lot of concern about clinicians being overwhelmed by work-related stress and demand. This leads to sickness and reductions in service.

There will be times when the work demand will exceed capacity. In this situation, you may need to contact 111 or contact us the next working day.

Can I choose which GP I want to manage my problem?

One of the Patchs questions asks if you have someone you would prefer to speak to regarding your condition. It will depend on who is working that day doing the triaging and will be subject to appointment availability.

Will this help the telephone system?

We hope if more patients use the online system. It will significantly reduce waiting times on the phone for those who need to call for other reasons.

Is there any guidance available for registering with Patchs?

Yes, we’ve created a short video explaining the registration process for you below.