Skip to content
Search

Latest Stories

New triage system could risk patient safety, GPs warn

“The new system risks patient safety, a growing workload burden and the emergence of a two-tier healthcare system”

New triage system could risk patient safety, GPs warn

NOTTINGHAM GPs have raised concerns about a new ‘virtual triage’ system, which has dramatically cut the number of patients able to access specialist neurology services.

According to them, the new system risks patient safety, a growing workload burden and the emergence of a two-tier healthcare system, the British Medical Association said.


The number of patients in Nottingham with the rejection of referrals or advice and guidance being issued in 40 per cent of cases in 2022, up from just 7 per cent of cases in the 12 months before the pandemic.

Nottingham University Hospitals NHS Trust, which runs the two biggest hospitals in the city, said it had introduced the new system owing to ‘greatly’ increased referrals and a lack of staff.

During the last six months of recorded data – covering November 2021 to April 2022 – there were, on average, 428 referrals a month. In the six months leading up to March 2020, that number was 611.

Dr Irfan Malik, a GP in Sherwood in North Nottingham, said he feared for patient safety – and was having to advise people to consider private healthcare because accessing services was becoming so difficult.

"We only refer when we absolutely have to, but more and more referrals are being rejected with advice and patients not seen. Every referral is becoming a battle and a struggle – they send a letter back with lots of advice and things to do and other referrals to make. The patients are getting stuck and they still have the problems they initially had," Dr Malik said.

"It is incredibly frustrating. In some of my clinics more than half of the people are waiting for something to be done in hospital and are stuck. What can we do? It feels like people will get more and more poorly and some will have bad consequences."

BMA East Midlands co-vice chair and Nottingham GP Kalindi Tumurugoti said the problems were causing significant issues around workload too.

"Any referral that is rejected or returned generates a huge amount of work in general practice. It is a case of seeing what to do next, looking at further investigations, considering pain relief and medicine management and trying to access MRIs or other steps that may be required. We are already a stretched and demoralised workforce and this is effectively going to give patients second-class treatment," he said.

NHS leaders in Nottingham said they introduced the ‘virtual triage system’ for outpatient referrals ‘in line with national guidance’ and ‘co-designed with primary care partners’ to address the challenges raised during the pandemic in July 2020.

Michael Wright, chief executive of Nottinghamshire local medical committee, said local GPs had raised concerns that the increased use of advice and guidance is ‘effectively a way to control workload rather than address genuine clinical need’.

"This also causes practices extra work and GPs would feel that they’ve discharged their contractual duties responsibly by referring the patient and would prefer to use advice and guidance when looking for pre-referral help as the name suggests – advice and guidance," Wright said.

The chair of Nottingham City Council’s health and adult social care scrutiny committee wrote to NUH late last year to express concerns from residents and GPs regarding access to neurology services.

NUH medical director Keith Girling said: "Our neurology service adopted a virtual triage system for outpatient referrals in line with national guidance. This was agreed and co-designed with local primary care partners and addressed challenges raised during the pandemic, catering especially for those in need of specialist care."

More For You

Sri Lanka seeks to negotiate with Adani over renewable energy plants

Gautam Adani

Sri Lanka seeks to negotiate with Adani over renewable energy plants

SRI LANKA’S government started talks with India’s Adani Group to lower the cost of power from two wind power projects the group will build in the island nation’s northern province, the cabinet spokesman said last Tuesday (28).

Sri Lanka has been reviewing the group’s local projects after US authorities in November accused billionaire founder Gautam Adani and other executives of being part of a scheme to pay bribes to secure Indian power supply contracts. Adani has denied the allegations.

Keep ReadingShow less
Badenoch proposes stricter citizenship rules for all migrants

Kemi Badenoch delivers speech on January 16, 2025 in London, England. (Photo by Dan Kitwood/Getty Images)

Badenoch proposes stricter citizenship rules for all migrants

CONSERVATIVE PARTY on Thursday (6) proposed a clampdown on all migrants by tightening citizenship rules and barring social benefit claimants from residency rights.

Kemi Badenoch, who took over from Rishi Sunak in November last year, outlined her first major policy agenda as Tory leader in a move seen as an attempt to win back the support of Conservative voters drawn to the far-right anti-immigrant Reform party.

Keep ReadingShow less
New body led by Sir Sajid Javid aims to amplify ‘unheard’ voices
Sajid Javid

New body led by Sir Sajid Javid aims to amplify ‘unheard’ voices

A NEW independent commission to improve cohesion would engage across all nations and regions of the UK by moving beyond Westminster-centric discussions and include more diverse voices, the director of British Future thinktank has said.

Sunder Katwala said building confidence across different groups will be a priority, as economic pressures and tensions due to Middle East conflict have polarised communities in the UK.

Keep ReadingShow less
Yarl’s-Wood-detention-centre-Getty

In 2018, she was detained at Yarl’s Wood detention centre after being told she would be deported. (Photo: Getty Images)

Court awards £100,000 to Pakistani asylum seeker over unlawful detention

A PAKISTANI asylum seeker has been awarded nearly £100,000 after a UK court ruled that she was unlawfully detained and subjected to breaches of her rights by the Home Office.

Nadra Almas, who arrived in the UK on a student visa in 2004, overstayed after her visa expired. She argued that returning to Pakistan would put her at risk as a Christian.

Keep ReadingShow less
Pakistan court gives unusual punishment to Youtuber Rajab Butt for owning lion cub

Pakistani zookeeper Mohammad Amir holds the confiscated lion cub at Lahore’s safari zoo last Tuesday (28)

Pakistan court gives unusual punishment to Youtuber Rajab Butt for owning lion cub

A PAKISTANI YouTube star who was gifted a lion cub on his wedding day avoided jail after promising a judge to upload animal rights videos for a year.

Rajab Butt has one of the largest online followings in south Asia, and his week-long nuptials in December were plastered over celebrity gossip websites.

Keep ReadingShow less