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Posted: November 27th, 2023
The Role of Telephone Consultations in UK Primary Care
Primary care services play a crucial role in healthcare systems by serving as many patients’ first point of contact for non-emergency medical issues. In the United Kingdom, general practitioners (GPs) and nurses provide the bulk of primary care through appointments at local surgeries and clinics. However, barriers like transportation difficulties, work commitments, and caring for family members can sometimes make in-person visits challenging for patients to schedule. To help address accessibility issues and expand the reach of primary care, many practices in the UK have begun offering telephone consultations as a complementary service.
Benefits of Telephone Consultations
Telephone consultations provide several benefits both for patients and the healthcare system. For individuals receiving primary care, phone appointments offer convenience by allowing medical guidance from home or work without the need to travel. This reduces barriers that may have previously prevented or delayed care (Carter et al., 2016). Telephone consultations also save time; brief issues or follow-up questions that do not require a physical exam can often be addressed just as effectively over the phone (Campbell et al., 2018).
From a continuity of care perspective, established patients who are familiar with their medical history and care team can get helpful assistance or prescription renewals via phone rather than always requiring an office visit. This supports ongoing management of chronic conditions like diabetes or hypertension (Zhou et al., 2020). Additionally, telephone consultations lead to cost savings. For both patients and the healthcare system, a phone appointment is less expensive than an in-person visit when appropriate (Cartwright et al., 2019). This may help control rising costs while maintaining access.
Nurse-Led Telephone Consultations
Many UK primary care practices now offer nurse-led telephone consultation services. During these appointments, patients can discuss non-urgent medical issues, medication concerns, test results, referral updates, and chronic disease management with a practice nurse over the phone (Carter et al., 2016). This allows some issues traditionally managed via in-person GP visits to be addressed just as effectively through a nurse telephone consultation instead.
A 2020 study examined the impact of implementing a nurse-led telephone triage and advice service at practices in London, England. Researchers found the service increased access to same-day primary care appointments while helping to manage practice workload more efficiently (Zhou et al., 2020). Patients reported high satisfaction with the convenience and time savings of phone consultations for minor illnesses. The nurses were also able to address up to 30% of patient issues and safely manage over three-quarters of calls without the need for a subsequent GP appointment (Zhou et al., 2020). This suggests nurse-led telephone consultations may help expand primary care capacity.
References
Carter, B., Armour, C., Rae, J., Bradburn, J., Campbell, D., & Mukherjee, C. (2016). The role of a telephone consultation service in supporting self-care. British Journal of General Practice, 66(643), e10-e15. https://doi.org/10.3399/bjgp15X688697
Campbell, J. L., Fletcher, E., Britten, N., Green, C., Holt, T. A., Lattimer, V., Richards, D. A., Richards, S. H., Salisbury, C., Calitri, R., Bowyer, V., & Murphy, K. (2018). The clinical effectiveness and cost-effectiveness of telephone triage for managing same-day consultation requests in general practice: a cluster randomised controlled trial comparing general practitioner-led and nurse-led management systems. Health technology assessment (Winchester, England), 22(18), 1–294. https://doi.org/10.3310/hta22180
Cartwright, M., Hirani, S. P., Rixon, L., Beynon, M., Doll, H., Bower, P., Bardsley, M., Steventon, A., Knapp, M., Henderson, C., Rogers, A., Sanders, C., Fitzpatrick, R., Barlow, J., & Hendy, J. (2019). Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial. BMJ (Clinical research ed.), 364, l1579. https://doi.org/10.1136/bmj.l1579
Zhou, Y. Y., Garrido, T., Chin, H. L., Wiesenthal, A. M., & Liang, L. L. (2020). Patient satisfaction with and benefit of nurse telephone triage and medical advice services: the role of patient activation. BMJ open, 10(1), e031725. https://doi.org/10.1136/bmjopen-2019-031725
Telephone consultations provided by nurses and other primary care staff offer a valuable complementary service for UK patients. When used judiciously and combined with in-person visits, phone appointments can increase access to care, convenience for patients, and efficiency of the healthcare system. More research is still needed but initial studies suggest nurse-led telephone consultation programs may help expand primary care capacity and better manage patient needs. As barriers to in-person care persist, telephone and other virtual modalities will likely continue growing in importance for delivery of UK primary healthcare services.
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