Patient Triage: New GP Contract Changes

The options in the dropdown list try to reflect common routine appointment types/reasons for care carried out in primary care, and the list was constructed based on discussions by our clinical team and conversations with practices. We acknowledge that there might be some aspects of care that are not delivered by certain practices, but these represent types of routine care that a patient may feasibly reach out to a practice for.

As the form does not book care directly and instead surfaces the request within the inbox, practices can respond as they normally would, for example, if there is no in-house smoking cessation service, you can reply with directions to local or national stop smoking services and resources to support your patients. If you feel there are more appointment types that could be offered here, please share your feedback through support@accurx.com or by clicking the green message icon in the bottom right corner of our website or help centre.

How practices achieve compliance with contractual requirements around online access is a decision for each practice, often in partnership with their respective ICB. While we develop features to support communication between practices and patients, there isn't a specific sign-off, for example, from NHSE, for functionality built against contractual requirements, and the ability to maintain compliance extends beyond software alone.

We understand there's some uncertainty about how patient access requirements may change and how they'll evolve, but we want to assure you that we'll continue to be responsive to feedback and make necessary updates as required for you and your patients.

We currently allow you to customise the “opening hours” for your forms in general. This is for consistency across the product, for patient experience, and to ensure alignment with the customisable boxes that surface across all forms. Once this time is configured, you can choose which forms to have open outside of these hours (medical and admin/admin only / no forms live).

The yellow banner message, which can be customised, will update when forms are accessed outside of these defined hours, so you can provide instructions and set expectations for patients at different times of day. We welcome feedback on the configurability needs practices have for their forms.

Patient Triage can still cap requests at a certain number and manually suspend online forms as needed. These features have been historically widely requested and valued by our users to support their workflows.

While compliance with the contractual requirements is something each practice decides, often in partnership with their respective ICB, if you would like a configuration where the medical form closes before the admin form (based on capacity) and all forms close at 6:30pm, you can set your opening hours from 8:00am to 6:30pm, with both forms closed outside of these hours. You can then make use of the capping feature (number of requests) to limit according to capacity, and manual suspension as needed during the day.

We know the BMA is in active discussion with NHSE regarding safeguards at the disposal of practices to support safe access, and we await the outcome of these discussions as the negotiations evolve. We are keeping an eye on how things progress, and we'll continue to be responsive to feedback and make necessary updates as required for you and your patients.

The new “routine care” addition to Patient Triage establishes a route for patients to arrange routine care, where they would have previously used other forms to communicate this with their practice. We had overwhelming requests from practices that having the new “Routine Care” addition to the admin flow available ahead of October 1st would make the transition easier, so they weren't adapting to this at the busiest time. This is why we’ve brought the changes live a little earlier, to give practices time to configure their new workflows in preparation for the 1st October.

The addition of routine care is part of the wider Patient Triage form rather than a standalone feature, so it isn’t something practices can turn on or off separately. It’s designed as an addition to the existing admin flow, helping practices capture the right information for routine requests while still managing demand in one place.

The new request type is called Routine care appointment because we believe it is the clinicians who are best equipped to determine the urgency of a patient's needs. The term Routine care clearly describes the purpose of the form—for routine appointments only—while avoiding the need for patients to self-diagnose urgency

Additionally, the red flagging and yellow banner make clear that it shouldn't be used for emergencies or new and ongoing symptoms.

Although there is a risk of patients adding information inappropriate to the request type or urgency in any free text field, we know that free text fields are extremely valuable in allowing patients to articulate themselves, and for healthcare professionals to have the information necessary to deliver care. Across the product, we have mitigations in place to reduce the risk of patients entering inappropriate information in these free-text boxes, including:

We recently made the decision to remove a free-text field from the “routine care” form, due to feedback upon release around how patients were submitting medical queries here and plan to iterate and improve the form as time goes on.

The ability for patients to request routine care appointments - health checks, long-term condition reviews, medication reviews, etc. - was built in response to:

We have created the form with safety in mind and have warnings in place to state that this is not to request support for new symptoms (which is what the medical request form is designed for), and also have only a pre-defined list of appointment types that can be arranged, with no current ability to add free text.

This form supplements the existing options within the admin form and is designed to facilitate patients in the administrative task of arranging routine care. It is an integral part of the “admin” options that we offer, and so cannot be configured separately from the rest of the “admin” form. We welcome feedback about this form, its use and the appointment types listed to factor into any iterations we might plan for practices and patients.