How to make triage decisions

2. What are the main topics of this request? (Optional)

This refers to what is written by the patient in their request - not what they tell you on the phone (if you phone them!). This information is important because it:

1. Teaches Topic AI to give patients messages based on the clinical topic of their request. Click here to read more about Topic AI. Examples include:
   • Depression - PHQ-9 questionnaire
   • Anxiety - GAD-7 questionnaire
   • UTI - specific questions regarding important questions for UTIs e.g. dysuria, frequency, haematuria, fever, rigors etc
   • Sore throat - FeverPAIN criteria
   • Back pain - back pain red flags and STarT Back questionnaire
     
   • Autism and ADHD assessments
2. Collects data on the types of requests patients submit to your practice. Which can be helpful for working out what type of clinicians you may need to deal with PATCHS requests.

3. Ideally, who do you think should have dealt with this message?

You should answer this question in terms of what should happen in ideal world if this same request was submitted again in future. For example:

• You're a GP. The patient has athlete's foot, which they could have got treated at a pharmacy - but you gave them a prescription for anti-fungal cream anyway. You should choose 'Pharmacist outside my practice (e.g. minor ailments scheme)'.
• You're a receptionist. The patient has chest pain and you advised them to go to A&E but they refused and asked to speak to a GP instead. You assigned the request to a GP to deal with urgently. You should choose 'A&E / 999'.

It doesn't matter if you don't have a particular service nearby, like a pharmacist that can deal with minor illnesses - you should answer what should happen in an ideal world. Answering this question is important because it:

1. Collects data for your practice on the appropriateness of requests submitted to you. You can then review view them in your Request reports.
2. Teaches PATCHS AI when to send similar requests to other people or services in future to reduce your workload. For example, it teaches Assign AI when to assign requests automatically to clinicians in your practice, and it teaches Signpost AI when to advise patients to attend A&E or call 999, or self-care.

The options to choose from are:

• Me. You are the right person to resolve the request. You should only choose this option if you are clinically the most appropriate person to resolve the request so that PATCHS is taught properly. If you are a receptionist and the patient requires input from a clinician, you shouldn't choose this option - you should instead choose the next option below and assign the request to the clinician to complete in PATCHS.
• Patient themselves (e.g. self-care). You think the request should not have been submitted to your practice at all, and the patient should have instead resolved the request on their own. Don't select this option though if you have given advice to the patient that only you could have provided e.g. reassurance about a potentially serious condition.
• Pharmacist outside my practice (e.g. minor ailments scheme). The request should not have been submitted to your practice at all, and the patient should have instead gone to a pharmacist to resolve their request.
• A&E / 999. The request should not have been submitted to your practice at all, and the patient should have instead gone to A&E or called 999.
• Dentist. The request should not have been submitted to your practice at all, and the patient should have instead gone to the dentist.
• Receptionist.* A receptionist could have resolved the request, but you have dealt with it anyway. Or, choose 'Someone else in my practice' and assign it to them instead.
• Pharmacist inside my practice.* A pharmacist could have resolved the request, but you have dealt with it anyway. Or, choose 'Someone else in my practice' and assign it to them instead.
• Secretary.* A secretary could have resolved the request, but you have dealt with it anyway. Or, choose 'Someone else in my practice' and assign it to them instead.
• Nurse.* A nurse could have resolved the request, but you have dealt with it anyway. Or, choose 'Someone else in my practice' and assign it to them instead.
• Advanced practitioner.* An advanced practitioner could have resolved the request, but you have dealt with it anyway.
• Physiotherapist.* A physiotherapist could have resolved the request, but you have dealt with it anyway.
• OOH service (including NHS 111) The request should not have been submitted to your practice on this occasion and the patient should have instead used an OOH service, including NHS 111

4. What actions are required from you to resolve this request?

Answering this question is important because it:

1. Collects data for your practice on your activity and workload. You can then review view them in your Request reports.
2. Teaches PATCHS AI how to flag cases that may need additional work. For example, it teaches F2F AI when a patient may need a face-to-face appointment so you can book them in directly, and it teaches Sick/Fit note AI when a patient may need a sick note completing so it can ask the patient to give all the details you need up front to fill it out.

The options for clinical staff are:

• Give patient information (e.g. advice)
• Order tests (e.g. blood tests, X-ray)
• Prescribe new medication
• Re-authorise / issue repeat medication
• Make a referral (e.g. to a specialist)
• Signpost to another service (e.g. IAPT, physio)
• Fill out paperwork (e.g. Med 3, TWIMC letter)
• Telephone patient
• Video call patient
• See patient face-to-face
• Visit patient at home
• Mark as duplicate (e.g. if patient chasing)

The options for non-clinical staff are:

• Give patient information (e.g. advice)
• Issue medication (e.g. repeat)
• Signpost to another service (e.g. pharmacy, DNs, physio)
• Book pre-agreed appointment (e.g. blood test, smear, decision by GP). This option should only be used to book a GP appointment after a GP has assigned a triage decision saying they need an appointment.
• Chase something (e.g. results, referral, prescription)
• Telephone patient
• Mark as duplicate (e.g. if patient chasing)

You should select as many actions as you think are relevant to resolve the request. Each time you do this you are teaching PATCHS that similar requests will need this amount of work to resolve them in future.