Authors' objectives:

This paper addresses the question 'Is the introduction of a local nurse telephone triage (NTT) in primary care likely to deliver health care benefits additional to those of the current (and future) system of NHS Direct?' To do this we reviewed the literature on effectiveness and the cost of local NTT.

This paper should be read in conjunction with 'Telephone triage services: systematic review of the literature and survey of Canadian call centre programmes' by Stacey D et al, CCOHTA, Ottawa, Canada, 2003. Obtainable from: http://www.ccohta.ca/publications/pdf/180_teletriage_tr_e.pdf .

Authors' results and conclusions: A current systematic review of the effectiveness of local NTT systems was identified and critically appraised according to QUOROM criteria. The review was generally of good quality. Reviewers found that there was a paucity of studies on both the effectiveness and the cost of NTT. On the basis of available evidence the major conclusions of the review were: i) NTT reduced immediate GP visits without causing adverse outcomes. ii) About 50% of calls can be managed by telephone alone. iii) The majority of callers are satisfied with the service and would reuse it. iv) NTT is cost saving when provided as an out of hours service in a primary care setting. A survey of Primary Care Trusts across the West Midlands was conducted to assess the extent of current and planned local NTT systems. Response rate to the survey questionnaire was 33%. Amongst responders the current development of local NTT systems was relatively limited but most responding PCTs were either implementing a system or were seriously considering doing so in the light of the new contractual arrangements for general practitioners.

Authors' recommendations: The limited available evidence indicates that local NTT in primary care is effective and as an out of hours service is likely to be cost saving. However the rationale of introducing such systems depends on the timing, scale and manner of implementation of published national plans for integrating NHS Direct with primary care.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/WMHTAC/REPreports/2003/nurse_triage.pdf This paper should be read in conjunction with 'Telephone Triage Services: Systematic review of the literature and survey of Canadian Call Centre Programmes' by Stacey D et al, CCOHTA, Ottawa, Canada, 2003 - obtainable from: http://www.ccohta.ca/publications/pdf/180_teletriage_tr_e.pdf

Year Published: 2003

URL for published report: http://www.birmingham.ac.uk/research/activity/mds/projects/HaPS/PHEB/WMHTAC/REP/reports-list.aspx

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: West Midlands Health Technology Assessment Collaboration

Contact Address: Elaena Donald-Lopez, West Midlands Health Technology Assessment Collaboration, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT Tel: +44 121 414 7450; Fax: +44 121 414 7878

Contact Name: louise.a.taylor@bham.ac.uk

Contact Email: louise.a.taylor@bham.ac.uk

Copyright: University of Birmingham