1. GP Social Enterprise led Call Handling & Nurse Triage Project
Powys Teaching Health Board

2. Summary of the Project
This Project aims to develop a sustainable model of patient streaming and nurse assessment and treatment, deployed at GP Practice level, in order to:
Improve access for patients
Improve effectiveness through ensuring appropriate care interventions
Improve efficiency through reducing inappropriate assessment and/or intervention
Improve Practice sustainability through shared resource and costs
This will change the flow through primary care by providing appropriate alternatives to GP assessment and intervention

3. Primary and Community Care
Why was it chosen?
95% of all care is accessed in Primary and Community Care. A 1% change in P&CC results in a 20% change in Secondary Care
Primary and Community Care
Interface
Secondary care
Inaccessible P&CC services lead to avoidable pressure in other parts of the care system
An increasingly unsustainable workload for GPs leads to an increasingly unacceptable delay in accessing services

4. Outcomes Effectiveness Access Efficiency
Nurse Triage (for urgent GP appointment requests only): 17,000 encounters. 61% redirected to services other than GP (17.4% received advice only).
Total Triage (for all GP appointment requests): 5,000 encounters. 43% redirected to services other than GP.
Access
Routine GP appointment time wait reduced from 14 days to 3 days
Efficiency
All GP appointment slots increased from 10 minutes to 15 minutes
Reduced DNA rates
Improved staff morale (GPs and Nurses)
Improved continuity of care

5. Lessons Learned Reduces avoidable demand and improves access
Can be applied to urgent and routine requests
Can be delivered by one Practice for other Practices
Need to train more Advanced Nurse Practitioners to avoid “robbing Peter to pay Paul), and training them takes time
Upskilled Triage Nurses become more marketable
GPs need to build trust in the Triage Nurses for the team to work effectively
Empowers nurses and improves continuity of care for patients
Practices, and individual GPs need to be ready to embrace it before implementation