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Digital triage in urgent care: How can research findings drive improvement in service delivery?

Thursday 23rd June 2022 - pm (online event)

With Ash Sexton, Dr Helen Atherton, Dr Gary Abel, Dr Jo Parsons and Professor Jeremy Dale

Event summary

The event aims to build a collaborative approach to research and service improvement though connecting urgent care providers, technology providers and the research project team. It will highlight key findings from a PhD research findings, and will demonstrate how digital triage data can be used to gain insight on urgent care service improvement needs. This will be followed by discussion on how services can be improved based on the research and how digital triage data can be further leveraged to drive service improvement.

Background and the research project

Every month the NHS 111 telephone service triages over a million calls. Those assessed as needing urgent clinical attention (approximately 50% of these calls) are referred to secondary triage. There is very little evidence of the safety and effectiveness of triage and its impact on emergency services, emergency departments and wider urgent and routine care. The PhD research addressed this gap in the evidence by investigating the accuracy, safety and experience of triage, comparing secondary triage outcomes with those from NHS111.

The PhD has analysed a large dataset of over 200,000 calls that were referred from NHS111 to secondary triage using the Odyssey TeleAssess clinical decision support software. The findings showed a high percentage (over 70%) of calls were downgraded (made less urgent) in secondary triage, suggesting that NHS 111 may be risk averse. Another key finding is that some calls, including a small proportion about potentially life-threatening symptoms, are upgraded to emergencies, suggesting that clinical risk has been underestimated in some cases by NHS111. The project will investigate these findings further, through the analysis of real patient outcomes (A&E attendance and hospitalisation) following triage.

The event will explore how research findings and future work could be translated into improved service delivery.

Who is running the event?

The event is being organised the University of Warwick (PhD student Ash Sexton and supervision team: Dr Helen Atherton and Dr Jeremy Dale and wider research team: Dr Jo Parsons and Helen McGowan). It will be run in collaboration with industry partner Advanced Health & Care Ltd.

Who is the event aimed at?

The event aims to develop collaborative approaches with stakeholders including UK based urgent care service providers, commissioners of urgent care services, NHS Digital, the Care Quality Commission (CQC), and patient representatives. It is the opportunity for you to input into the development and translation of research in a way that will benefit service delivery.

What will be covered in discussion sessions?

We’d like to get your input on any of the following areas:

  • Which findings are most useful, interesting, or unexpected for your organisation?
  • What do you think are the key problem areas?
  • What information is needed?
  • Which parts of the research should be developed further to inform service improvement?
  • How can digital triage systems address the challenges or issues that are revealed by this research?
  • How might policy, service providers, technology providers and research work together to improve urgent care services?
Why this research is beneficial?

Digital triage is central in the delivery of urgent care, improvements within digital triage and service delivery would help to better direct patients to appropriate care. The effective delivery of digital triage within urgent care has implications on how wider health care services, including general practice and emergency care are used. This work is particularly timely due to extremely high workload pressure on these services. For this research to be of most benefit, we seek to develop a more collaborative approach with stakeholders through this event.