Protocol for Emergency Appointments

When patients call each morning asking for an urgent appointment, if it is deemed to be a medical emergency which cannot wait until the next routine slots, these patients should be allocated an appointment as follows:

  • Book a telephone triage appointment. Each doctor and nurse practitioner has four, five-minute telephone triage appointments close to the beginning of their surgery. If the clinician calls the patient and decides they need to be seen that day, the clinician who has triaged the patient over the phone, should arrange to see that patient themselves at the end of their surgery.
  • If the patient needs to be seen face to face that same day, please offer a Book on the Day Appointment with a clinician, ideally with their own doctor first, or with another clinician if their own doctor is not available. For example, if their own doctor is fully booked, please offer a book on the day appointment with a GP associate or nurse practitioner.
  • Urgent children under two years of age should automatically be added to either a book on day slot or as an extra at the end as these children if URGENT will need to be seen.
  • Once the Book on the Day and Telephone Triage slots are taken, please add any extras as telephone triage appointments to the end of the usual doctor’s list. A specific time cannot be offered for these telephone calls. Please tell patients they may be called at any time. Please mark urgent telephone triage with an alert on screen, notifying the doctor that they should prioritise the call.
  • Telephone triage for GPs who are absent should be shared amongst all consulting clinicians (including GP Partners, Associates and Nurse Practioner) to enable equitable workloads. For example, every clinician gets allocated one extra telephone triage call before allocating a second extra telephone call to a particular clinician.
  • The on-call doctor should not receive more urgent telephone triage appointments than any other clinician as they often have other urgent queries to deal with in addition to their own surgery.
  • Receptionists should not add any patients as extra face to face appointments without speaking to the clinician concerned. All extra appointments should be assessed by a clinician through telephone triage and it will be the responsibility of that clinician to complete the consultation, either over the phone or bring down and see themselves if required. Therefore, there should be no “sit and wait” appointments.
  • Patients should not be advised to call back in the afternoon or the next day, they should be given an appointment (pre-book routine or emergency book on the day), or telephone triaged if no appointments available. Please do not add anything to clinician’s list from 11:00 onwards to enable time for admin, prescriptions and home visits. From 11:00, all queries should be directed towards afternoon slots.

All clinicians and receptionists are advised not to fill up book on the day slots in advance, or add extras on for the following day. This applies to both face-to-face appointments and telephone consultations. Specialist appointments that are not filled by the evening before, can be opened up as more book on the day appointments eg diabetes, family planning and COPD appointments