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Tele-First: telephone triage as an alternative to face to face contact in general practice

The aim of this study was to evaluate a ‘telephone first’ approach where patients wanting to see their GP were asked to speak to them on the phone before being given an appointment. 147 practices adopting this approach were compared with 10% random samples of other GPs in England in GP Patient Survey scores and secondary care utilisation. The study involved practice manager survey in ‘telephone first’ practices, analysis of practice data and patient surveys conducted in 20 practices using the ‘telephone first’ approach, interviews with 43 patients and 49 primary care staff. 150 participants from 4 practices in CRN Eastern took part in the study. The telephone first approach showed that many problems can be dealt with a GP on the phone. The new telephone first approach resulted in more phone calls, fewer face to face consultations, and, on average, more time spent consulting. The approach does not suit all patients or practices and is not a solution for appointment demand. There was wide variation between individual practices, including large increases and large decreases in workload after adoption of the telephone first approach. There was no evidence that the telephone first approach would reduce costs of secondary care. Access to BMJ online full publication here