Intended for healthcare professionals


Formalising triage in general practice towards a more equitable, safe, and efficient allocation of resources

BMJ 2022; 377 doi: (Published 24 May 2022) Cite this as: BMJ 2022;377:e070757
  1. Daniela Rodrigues, doctoral student1,
  2. Noemi Kreif, senior research fellow in health economics2,
  3. Kavitha Saravanakumar, associate director of business intelligence3,
  4. Brendan Delaney, chair in medical informatics and decision making1,
  5. Mauricio Barahona, chair in biomathematics4,
  6. Erik Mayer, transformation chief clinical information officer15
  1. 1NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
  2. 2Centre for Health Economics, University of York, York, UK
  3. 3North West London Clinical Commissioning Group, London, UK
  4. 4Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK
  5. 5Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to: D Rodrigues d.rodrigues{at}

Daniela Rodrigues and colleagues argue that triage of all patient requests in general practice could help practices managing demand with limited resources

In response to the covid-19 pandemic, general practices in England were advised to implement the “total triage” model in which every patient is triaged before booking an appointment.12 Triage refers to the process of choosing the most appropriate time, mode of consultation (eg, in-person or telephone) and healthcare professional (eg, general practitioner (GP) or nurse) to manage each patient request according to clinical need.2 This model was primarily aimed at minimising the spread of SARS-CoV-2 in the community and in healthcare facilities by reducing the numbers of patients seen in person, but similar triage initiatives had already been proposed and piloted across the country before the pandemic345 in response to the increasing imbalance between patient demand and availability of GP appointments.67

In disaster settings, triage is crucial because the need for healthcare is typically higher than the available resources and delays in the provision of care could be fatal.8 The key assumption behind triage in less acute settings where demand exceeds capacity, such as UK general practice,67 is that it can similarly promote a more equitable, safe, and efficient allocation of resources.9 Although the preferred medium for triage in general practice has been the telephone, interest is growing in using online triage platforms that allow patients to submit a form with their health problem and query to their practice.10111213 Online triage platforms were highlighted in the recovery plans for the NHS for 2021-2214 and 2022-2315 as a channel to embed triage in general practice. They were further stipulated in the general practice contract agreement16 and the investment and impact …

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