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PhD travel grant


The MWA PhD travel grant has benefited Ash Sexton immensely. Ash is aiming to investigate how telephone-based digital triage, used in cases of urgent out of hours care, can be improved. The international perspective the grant offers gave her research a wider context and is aiding the dissemination of her findings.

PhD travel grant deadlines

How did this work?

Ash, a PhD student from the University of Warwick, visited Monash after being awarded an Alliance PhD Travel Grant. Associate Professor Kelly-Ann Bowles, Director of Researcher and Honours and Higher Degree Research Coordinator - Paramedicine, hosted Ash during her visit. Professor Bowles is currently working on a Alliance collaboration on Quality Improvement in healthcare.


Digital triage

Ash started her PhD at Warwick Medical School in October 2019 and is looking to complete her research in March 2023. Her research focuses on telephone based digital triage in UK based urgent care delivery. Her interest in patient outcomes includes experience, safety, and patients’ subsequent use of healthcare. Her mixed method project requires identifying patterns in large datasets.

Risk and emergency response

Digital triage involves call handlers or clinicians using software to assess the patient’s symptoms, identify the urgency of the problem and subsequent advice. Advice may include referral or signposting to other services. Within England, Ash found that patients calling the national NHS 111 service initially speak with a non-clinician with no medical training and approx. 24% of these callers are referred to emergency services, 15% are referred to self-care, 8% are referred to another service. Ash’s research is evaluating the 50% of callers undergo a secondary triage with a nurse.

Professional Development

The MWA PhD travel grant has benefited Ash Sexton immensely, as it provided her with opportunities to present her research to many different groups, including Ambulance Victoria, the department of General Practise and the department of Paramedicine at Monash University. She has also gained an understanding of differences and similarities between the national models of care between the UK and Australia.


“I'm looking to identify areas of clinical risk as in the 50% of calls referred to a nurse for secondary triage, only 2% are referred to emergency care following the nurse’s assessment. Understanding what happens in these calls is complex, for example my qualitative study has suggested callers may be down-playing their symptoms and therefore don’t perceive there is an emergency initially.” - Ash Sexton (PhD student)

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Findings from Ash’ initial review showed that patients with language barriers were often given priority, partly due to the communication challenges, so nurses tend to be more risk averse. Using regression modelling which factors in the top 20 symptoms callers present with, as well as other patient, and service level factors. One of her key findings is looking at high risk health concerns i.e., in which patients the nurse will upgrade the advice given by the non-clinician in the initial level of triage. She has identified that this occurs more in calls about chest pain & breathlessness therefore these calls may be considered high risk.

Ash hopes to look at a follow-on study which looks at focussing on the clinician / nurse experience and identifying the high- risk areas to ensure patients receive the best care. She is interested in continuing her research, and she would ideally like to focus on particularly high-risk patient groups. She also sees herself supervising other PhD students in the future.

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