Appointment System at Golden Valley

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We thought it would be a good opportunity to explain how the appointment system at Golden Valley Practice works, and in particular the role of our triage system. Each day there are a mixture of telephone and Face to Face appointments which are bookable in advance with a GP.

These can be booked online, on the telephone or via reception. Having these options has many benefits. Many problems can be dealt with over the phone, waiting times for appointments are shorter and it is often more convenient to the patient. If it is apparent that a Face to Face appointment is required during the consultation, it can either be arranged for the same day or shortly after (we have dedicated appointments that a GP can book into). 

Each day we have a dedicated triage clinician (either our Advanced Nurse Practitioner Sarah and Alison, or a GP) who deals with urgent medical issues that need assessing the same day. If a patient contacts the surgery with any such issue, they are placed on the triage list. 

Due to the nature of issues, triage appointments are designed to deal with only medically urgent issues whereas with routine appointments the clinician has more time to deal with problems and can give a more considered approach to an issue. The triage appointment list is usually extremely busy and the triage clinician has one of the most difficult jobs within the surgery. It is the triage clinician’s task to assess the patient over the telephone and decide whether the situation can be managed over the phone or whether the patient needs to be assessed in person.

This can either be with the triage clinician or there are several urgent GP appointments which can be utilised if they feel this is more appropriate. It may well be the triage clinician feels that the patients concerns are better dealt with by another health care provider (eg; an optician if a person has eye symptoms) or that a routine appointment is more appropriate.

Whilst this can be quite frustrating as a patient if you are wanting your concerns addressed straight away, it is important to remember that the triage system will only work if it is restricted to issues which are genuinely urgent and need dealing with the same day. It is not unheard of for there to be 40+ people on the triage list in one day.

Due to the nature of the work, problems have to be assessed in a concise, proficient fashion before the clinician moves onto the next challenge.

This allows us to get through the list in a safe, timely manner. Unfortunately, this can sometimes  be at the cost of not having a huge amount of time to discuss the patient’s situation in depth. In these situations, it would be more appropriate to book a follow up routine appointment, which naturally have more time to discuss such issues. 

We first employed an ANP and started our triage system back in 2019 when one of our Doctors was off for two months and we were unable to find a replacement GP. It is one of the most successful initiatives Golden Valley has introduced. It has allowed for any patient who phones with an urgent problem to be dealt with in a timely manner. This has improved the lives of our patients, our reception staff and clinicians immeasurably. 

In recent weeks we have had a few complaints from patients saying that they are being “fobbed of with a nurse” or that they “want to see a Doctor”. These statements are misguided. Sarah has successfully completed an advanced degree in urgent care and has a great deal of experience and knowledge in providing triage.

She is able to prescribe the same medications as the GP’s (when appropriate) and do referrals etc. In the course of my job, I automatically get to review the consultations which each health care professional provides and I can state without hesitation that Sarah performs at as good a level as all the Doctors we have working at the practice. 

I hope this helps everyone understand our appointment system. Please contact the surgery if you have any other questions. 

Esther Scotland

Senior Partner

June 2022