The Use of Triage in Primary Care in the UK: An Integrative Review and Narrative Synthesis.
Han Nah Park, Kyeongmin Lee, Carolyn Wallace
PMID 40590353WHAT IT FOUND
Nurse-led telephone triage in UK primary care shifted work from GPs to nurses, but some studies increased total contacts and showed mis-triage, low compliance and access inequities.
Key findings
01Triage was mostly nurse-led: in 13 of 20 included studies nurses performed triage, and telephone triage was used in 18 of 20 studies.
02In one included study, nurse telephone triage reduced GP appointments by 29% to 44%, but increased telephone care by 2.4 times and nurse care by 3.8 times.
03Safety and compliance concerns were reported: 3.2% of audited nurse triage calls were considered potentially dangerous, and 49% of NHS 111 callers followed advice.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only UK primary care studies were included, so findings may not apply where primary care works differently. The review combined randomised, quasi-experimental, descriptive and qualitative studies, so it could not pool results into a single estimate. Quality appraisal did not exclude weaker studies; included studies had issues such as unblinded outcome assessment, unclear outcome measures and nonresponse bias. Only 5 of 20 studies described triage education or training, and the details were not enough to compare programmes. Only 4 of 20 studies evaluated costs, so cost-effectiveness remains uncertain. Narrative synthesis relied on reviewer judgement, and different measurement scales made consistent interpretation difficult.
Declared interests
The authors declared no conflicts of interest. The work was funded by the National Research Foundation of Korea.
The easy way to misread this
Do not conclude that nurse-led triage is safe and efficient because patient satisfaction was high. Some audited nurse triage calls were considered potentially dangerous in 3.2% of cases, and only 49% of NHS 111 callers followed advice.