Appointment system upgrade

Overview

We wish to share some very exciting news about a significant change to our appointment system that will improve the way our surgery delivers care to all our patients.

GP surgeries across UK are moving to a ‘Modern General Practice’ model to make access to care and treatment easier for patients and help improve patient satisfaction. This is a national NHS project, and all surgeries must adopt the system eventually.

From 20 October 2025, we will start total triage via Patchs.

What is total triage?

Total triage is a general practice workflow where every patient contacting the surgery provides some information on the reasons for contact and is triaged before an appointment is made.

All patient requests will be triaged by one of our experienced GPs who will decide what the best course of action is. Where necessary, we might ask you to answer a few additional questions to help our doctor prioritise those patients who need more urgent care.

You could be given a face-to-face or telephone appointment, a reply from the GP with self-care advice, or you could be signposted to a more appropriate service.

The main purpose of the total triage model is to:

• enhance the quality of care our patients receive
• ensure patients are given the most appropriate appointment or advice to meet their needs
• communicate with patients in a timely way
• move away from first come first served approach to one based on patient needs

How does it work?

All patients will complete a Patchs form online which can be accessed via our website or the NHS App. If you do not have a smartphone or computer, you can telephone or visit the surgery and our reception team will complete a Patchs form on your behalf.

Once your Patchs form has been submitted, the GP will review your request and you will receive a response either offering an appropriate appointment or you may receive a message with advice from the GP.

Please note that for the GP to triage your request in a timely manner, it is very important to provide detailed and accurate information about your symptoms when you initially contact us. For example, if a patient has a cough, it would be much easier to triage the request with the following information:

“I’ve had a cough for 10 days. I have already used over the counter medicine, but it is not helping and in the last couple of days my cough has been worsening and it feels chestier. I also have a high temperature.”

If the information given is less detailed, such as “I’ve had a cough for 10 days,” it makes it harder for the reception staff and GP to triage and we may need to request further information which could delay treatment.

The total triage service will be open Monday to Friday, 8am to 6:30pm. During the weekend or bank holidays, please continue to use the 111 service or call 999 for life-threatening emergencies. Please note there may be times when we may temporarily suspend the online triage form to help manage the demand. In these circumstances, you may see:

• a message to advise that the patient triage is temporarily unavailable, including information on when the service will be active again and how to contact the surgery another way
• a message prompting you to use the NHS 111 service, to find a local pharmacy, or to attend an urgent treatment centre

How does this benefit you?

We know that change can be difficult sometimes, but we are confident that total triage will bring many benefits to our patients. For example:

• Total triage has been shown to reduce waiting times and it enables us to attend to your medical needs more promptly.
• Using digital communication will mean that you can engage with us from the comfort of your home or workplace.
• Triage ensures that limited healthcare resources are allocated to patients who need them most urgently.
• Total triage will address the increasing demand for appointments and reduce the frustration of having to call and be in a long queue at 8:30am.

If you have any questions or concerns our team is here to guide and support, you can contact the surgery.

Why is the surgery changing its appointment system?

The staff at St Georges Medical Centre, along with NHS England, have acknowledged the increasing demand for appointments and our capacity being unable to meet this demand. NHS England have published a paper outlining their similar concerns.

There are not enough GP appointments nationally to meet increased patient demand so we are needing to ensure only those who need to see a GP will get an appointment. What a patient may want is not the same as what they need. Many conditions can be managed by non-GP clinicians – this includes physiotherapists, pharmacists, mental health workers, social prescribers, and other members of the team. The NHS system is complex to navigate, and we recognise patients need help with this.

Total triage has been designed to ensure that patients who most need an appointment are able to get one, and to facilitate equality of access to care.

We understand how frustrating it can be for patients to wait in phone queues to get an appointment. We have also noticed that many patients are booking appointments that do not necessarily require one, and we are concerned that those who need to be seen are not getting seen at the right time.

NHS England has stated that there is good evidence that clinician triage and modern online tools make it easier to manage patient requests and involve the wider team, with higher patient satisfaction rates than with the more traditional model.

To address this issue, we are introducing a total triage model of care. This means that anyone requesting an appointment or advice will have their request triaged. Our online consultation forms provide us with key information about your problem, so that we can arrange an appointment at the right time with the right person if needed.

What if I have trouble using the new system?

We hope to support patients and their families/carers to get used to the new way of contacting the surgery and to become comfortable with this over time. We will, of course, provide additional support to those patients who are unable to use online services.

If you do not have online access or experience other difficulties using digital technology, please speak to our reception team about how we can help you in your usual way

Do I have to share personal information with a receptionist if I ring/walk-in?

It is important to provide as much relevant information as possible so that your request can be triaged appropriately. We understand that some issues may feel sensitive to discuss. Please be assured that our reception team are specially trained to ask the right questions and handle personal information with care. They are bound by confidentiality agreements, and their role is essential in helping us deliver safe and effective healthcare to all our patients.

Can I walk into the surgery to make an appointment?

We strongly discourage patients from walking in to make an appointment. Primary care has never been an emergency service – if a patient needs urgent medical attention, they should call the NHS 111 service or go direct to A&E if it’s an emergency.

If a patient walks in, they will be treated the same as anyone sending an online consult or ringing the surgery. The receptionist will ask you for details to care navigate you to the right service and will be added to the triage list to be assessed.

It does not speed up your enquiry. We manage all requests based on a safety system.

Do all appointments have to be booked this way?

All GP appointment requests will be managed this way but appointments for our nursing team can be managed via telephone such as for chronic disease annual reviews, blood tests, wound management, etc.

Why can’t I just book an appointment like I used to?

Across the country, GP capacity can no longer keep up with growing demand, so we need to implement systems that ensure every patient receives the most appropriate and safe care. Healthcare is evolving, and it is important that we adapt to these changes.

Who else might I be asked to see?

Not every health problem needs a GP. Over the last 5 years, we have significantly expanded our team. Health problems might require the following:

• Pharmacists
  We have our own highly trained clinical pharmacists and technicians at the surgery who manage all our blood pressure patients as well as complex medication issues.
• First contact physiotherapists
  They see all musculoskeletal problems and come up with a plan after assessing the problem. This may include further tests or referrals, and they link directly with the hospital.
• Social prescribers
  They help patients where they may have a social problem or health problems linked with social situations. They can see patients and families at the surgery or sometimes at home.
• Nurses
  Our experienced nursing team manage many chronic and acute conditions.
• Community pharmacies
  A new program called Pharmacy First has been set up to treat several minor conditions and they can prescribe antibiotics where appropriate.
• Community eye service
  Most eye conditions are managed by this team, and they link in with local optometrists.
• Dentists
  We are not able to manage any dental problems, even in emergencies. If you don’t have your own dentist, please ring 111 for advice on accessing care.
• Self-care
  Many conditions can be managed with advice and support.

Can I choose what time I come for an appointment?

For routine planned appointments, we will give as much flexibility as possible (subject to availability).

For urgent appointments, we expect patients to be flexible and will likely be asked to attend at any time between 8am to 6pm, subject to what we can offer. We do not have flexibility on these.

For urgent health problems, employers are legally expected to allow employees to attend these, including at short notice.

Why can’t I send a request when you are shut?

Primary care remains a Monday to Friday, 8am to 6:30pm service. There are other services available for urgent problems outside of this time. We have to manage demand on the surgery. Our surgery team work hard but also need to work within safe working conditions.

What happens if you are full?

We have carried out a lot of work looking at demand management and try to respond to predicted fluctuations in workflow. We have to remain safe – there has been a lot of concern about clinicians being overwhelmed by work-related stress and demand. This leads to sickness and reductions in service.

There will be times when the work demand will exceed capacity. In this situation, you may need to contact 111 or contact us the next working day.

Can I choose which GP I want to manage my problem?

One of the Patchs questions asks if you have someone you would prefer to speak to regarding your condition. It will depend on who is working that day doing the triaging and will be subject to appointment availability.

Will this help the telephone system?

We hope that as more patients use the online system, waiting times on the phone will be significantly reduced for those who need to call for other reasons.

Is there any guidance available for registering with Patchs?

Yes, we’ve created a short video explaining the registration process for you below.