In the last 25 years, the number of telephone consultations in general practice has increased significantly, whereas the number of consultations in patients' homes has decreased. A study of over 100 000 000 GP and practice nurse consultations found that the average consultation rate per person had increased from 4.67 in 2007-08 to 5.16 in 2013-14 (Hobbs et al., 2016). Telephone consultations over the same period doubled. With workload increasing consistently, in excess of both population growth and the number of primary care practitioners, use of telephone triage has increased. Evidence does not support this as a strategy to reduce clinical workload. It may have the harmful effect of reducing disease prevention activities (Hobbs et al., 2016). Although telephone consultations are usually shorter than face-to-face consultations (mean duration 5.4 minutes compared with 9-22 minutes (Hobbs et al., 2016)) caution is required when seeking to reduce workload and save time. Same-day telephone triage is not shown to reduce overall workload. Approximately one-third of telephone calls result in a subsequent surgery consultation (Campbell et al., 2014; Holt et al., 2016). The ESTEEM study found that following doctor triage, there was a 22 increase in patients seeking medical help out of hours (Campbell et al., 2014). The National Association for Patient Participation do not support telephone triage noting increased anxiety and use of urgent care for patients following telephone triage (Pereira Gray and Wilkie, 2017; Wilkie and Pereira Gray, 2016).
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