Reception Triage – What to expect

Booking an appointment – An explanation of reception triage

When you telephone the surgery to book an appointment, the receptionist will ask you the follow question:

  • “To help you make the correct appointment, I need to know a little more about why you need the appointment.”

The receptionist may also ask both/either/none of the following two comments, depending on your response.

  • “It is not always necessary to see the Doctor, a nurse/Healthcare Assistant may be more appropriate.”
  • “Whatever you say will be treated in the strictest of confidence.”

This is because the receptionist has a number of alternative types of appointments available to her, and she needs to offer you the most appropriate appointment to deal with your problem.

The most appropriate appointment may be with the GP for example, or perhaps with another member of the practice team.

In this way, on the occasion when you really do need to see a GP, there is more likely to be a free appointment for you.

The following tables may help you understand more clearly the choices available:

We very much hope that this system will make best use of the services available both at the practice and in the wider community, and by doing so indirectly increase the number of available GP appointments, so that you can more easily secure this when it is necessary.

  • The left hand side of the tables describes the details of the presenting problem.
  • The right hand side of the tables guides the receptionist’s response.

Option 1

  • Unconscious or collapse
  • Fitting
  • Severe chest pain
  • Severe shortness of breath

Consider or advise 999 – or ring on patient’s behalf, ensuring have patient’s correct address and tel number – let GP on-call or usual GP know straight away.

Take patient’s contact number and record telephone conversation into patient notes.

Option 2

  • Elderly or infirm with mobility problems (double apts where possible)
  • Terminal illness
  • Expected death

Morning

Either – arrange morning telephone appointment with GP – usual GP if possible. Advise patient a GP will call them back before the early afternoon.

Or – enter to visit screen, with message for GP to phone first

Option 3

  • Unexpected death

Let usual GP or on-call GP know straight away

Option 4

  • Children

Offer face to face appointment with usual GP or any available doctor as soon as possible if requested, or offer telephone appointment with GP if requested.

Option 5

  • Medication review

Check medication review to ensure that it truly is overdue. Then check diary dates. Book an appointment with Derry Downs clinical pharmacist.

For all other patients direct to the prescription supervisor

Option 6

  • Results

Most results can be given out as per GP’s comments on the computer.

The GP will comment if appointment required – either telephone appointment or face to face.

Book appointment as directed with appropriate GP

Option 7

    • Eye injury resulting in pain/effected vision

    Spec Savers in Orpington for Triage or Queen Mary’s Hospital eye emergency department.

    Option 8

    • Immunisations/Travel
    • Dressings/operation wounds
    • Smear
    • Contraceptive pill /HRT follow up/rpt prescription
    • Emergency contraception – to be seen that day
    • Chronic disease recall
    • Vaginal swabs (pre coil fit)

    Appointment with nurse

    Confirm appointment date and time

    For travel advice, advise patient to arrive early to complete a travel questionnaire at reception before seeing the nurse.

    If patient has ran out of routine contraceptive pill, offer them a 1 month supply to collect and routine appointment with nurse.

    If patient requires emergency contraception – book a same day appointment with Amanda

    Option 9

    • Scheduled blood test
    • Suture removal
    • Blood Pressure check
    • ECG
    • NHS Health Check

    Book appointment with Health Care Assistant (HCA)

    Confirm appointment date and time book with nurse or HCA

    • Blood Pressure check book with HCA.
    • ECG book with HCA.
    • NHS Health Check book with HCA

    Option 10

    Adult

    3 days or less of

    • fever only symptoms
    • sore throat
    • dry cough
    • vomiting
    • diarrhoea
    • cystitis
    • Thrush
    • Constipation
    • Hay fever

    1. Offer telephone consultation with GP

    – to enable GP to decide management including need for face to face consultation.

    Record telephone number – advise patient that someone will call them back that morning/afternoon. Patient may be asked to attend the surgery if appropriate

    Patients should keep the phone near them

    Or consider

    2. Pharmacy –

    Silversands or Osbons

    Community Services

    • Headlice
    • Sore throat
    • Teething pain (over 3 months old)
    • Toothache
    • Vaginal thrush
    • Threadworms

    Advise that Pharmacy

    Nearest Pharmacy First:

    Silversands or Osbons

    Option 11

      • Acute injury where fracture suspected

      Check medication review to ensure that it truly is overdue. Then check diary dates. Book an appointment with Derry Downs clinical pharmacist.

      For all other patients direct to the prescription supervisor

      Option 12

      • Acutre Injuries/cuts/burns

      Suggest Urgent Care Centre and give address.

      Option 13

      • Smoking cessation

      Health Care Assistant

      Option 14

      • Sick note request
      • Advise self certificate (SC2) for 1st 7 days of illness – available from employer or post office
      • Med 3 – 1st doctors note after 7 days sickness – please complete an econsultation
      • Extension – follow up sick note or 3rd party sick note – To be requested in writing and allow 72 hours for completion

      Option 15

      • Acute abdominal pain or chest pain
      • persisting skin rash+/- fever (inform GP immediately if headache, non blanching rash, neck stiffness, photophobia, loss of muscle tone, vomiting or any single or combination of these)
      • Shortness of breath/cough with spit
      • Suicidal thoughts or agitation
      • Excessive bleeding

      Appointment with available doctor

      Advise patient this is a 10 min slot and confirm the time given. Inform patient they must arrive 10 minutes before appointment time.

      Option 16

      • Sexual Health Screening / Services

      Book appointment Practice Nurse

      Or, suggest visit Osborn’s pharmacy who offer the following free services

      • Emergency Hormonal Contraception (EHC) – women aged 14 to 24 yrs
      • Free Chlamydia screening – women aged 15 to 24 yrs
      • C-card pick up point – young people aged 13 to 24 yrs