“The fundamental misconception politicians have about triaging is that for them it is a ‘bottom up’ process, non-medical unqualified people passing up problems to qualified professionals dependent on severity. The opposite is true however. Triaging should be done by the most experienced clinician and passed down the ‘chain’ according to expertise and experience. That would of course be unaffordable within current systems, which is why NHSD and 111 and whatever they will be replaced by in due course will be destined to fail“
In the comments Dr Hubertus Von Blumenthal makes clear what anyone with experience of out of hour’s care knows. Triaging isn’t the easy bit where you can cut corners and save money.
It’s time for the Ministers who are seemingly obsessed with iPhone Apps (or is it Maps??) for Smartphones to begin to appreciate the much more accessible opportunities we already have:
> Mobile phones have become the first consumer gadget to ever become as widely distributed as mankind and in rich countries like the UK there are more mobile subscriptions than citizens (making a mobile number a great way of identifying a patient – particularly if you’re offering informed telephone advice)
> The government would get unanimous support from mobile operators where it to ask them to make nhs.uk free to browse from a mobile browser (not least because it would be great for mobile internet discovery).
> There are clinically validated web based tools (like Instant Medical History – the interactive questionnaire tool we leverage as part of the documented consultations we offer at 3G Doctor) that can enable patients to document their own medical information so that experienced clinicians can make decisions on it and safely pass it “down the ‘chain’ according to expertise and experience” or indeed refer it on to the patients family Doctor (without the need to repeat everything or type it all up again).
> For patients who don’t have the ability to use these online tools the NHS could provide the 111 telephone service and because it won’t be chock full of patients (who could’ve used the internet to report their health concerns) these patients will have a much greater chance of getting their call answered.
If you think this isn’t something that the NHS could do check out the pioneering NHS work being done at the Haughton Thornley Medical Centres (part of the Tameside and Glossop Primary Care Trust) together with IMH UK and Wiggly-Amps (GP System Supplier).
“Having used the Medical History Questionnaire process for the first time today, I am most impressed with it and found it very straightforward and comprehensive. I am keen to continue using this approach, which clearly provides tangible benefits to both the Patient and the General Practitioner. The system appears safe and secure in use and was very easy to access online. It delivers time saving benefits, which in turn frees up the GP’s time from basic data gathering, enabling the Doctor to spend the available consultation time delivering an enhanced quality of patient care. I highly recommend this system for wider roll-out” J Webster, Patient
“Fantastic! I could not get such a detailed history in the 10 minutes I have to see the Patient. (The interactive questionnaire) Asks all the relevant questions and presents it in a quick easy to read format which can be part of your consultation… Brilliant” Dr Nadeem Ahmed, GP, Haughton Thornley Medical Centres