1. By
David Ross Garvey
RNMH
05th
April 2016

2.  ‘Any form of health care delivered on an
outpatient basis’.
 Any medical condition that does not need to
attend Accident & Emergency, which can be
treated, managed or referred to an alternative
health care provider within the community.
 (NWAS)

3.  Better management of resources.
 Increase the ability to direct patients to the
most appropriate care.
 Results we hope to achieve using effective
secondary triage
 Fewer emergency ambulances being utilised.
 999 resources available for life threatening
emergencies
 Reduced A&E attendances
 Customer satisfaction

4.  Patients own GP
 Out of Hours GP
 Walk in Centres
 Minor Injury Units/Urgent care centres
 District Nurses
 Mental Health Services
 NWAS Green Car
 Eye Hospital
 Maternity

6.  Best care for patients, at the right time and in the
right place.
 Ability to hear, treat, advise and redirect.
 Reduces pressures on Accident and Emergency.
 Reduces pressures on Paramedic Emergency
Services.
 Reduces pressure on service for statutory targets
and statistics.
 Secondary triage has the ability to do more jobs
than if each job was to receive an ambulance.

7.  Cost effective for the service.
 Increases profile of the service and increases
relations with other services
 Makes patients feel valued and have trust in
the service they use.
 Safe system which doesn’t compromise patient
care and easy access to other services.
 Identify life threatening calls that primary
triage (Pre QA) had missed.
 Can upgrade or close calls when completed.

8.  Understanding of questioning.
 Unable to see the patients condition.
 Inability to obtain baseline observations.
 Language and cultural issues.
 Clinicians can be over or less cautious when
triaging.
 Abusive callers and/or family members
making it difficult to triage effectively.

9.  Inability to contact patient back via telephone.
 Not seeing the environment.
 Inability to fully assess Risk.
 Pain scoring.
 Inability to assess patients under 16 unless its
consistent with Trauma.

10.  CMS directory of services
 Manchester Triage System
 C3
 Ability to review calls to ensure standards are
kept to a high standard.

11. 52 Discriminators.
5 point scale- response time indicators.
Patient safety is paramount.
Systematic approach.
Able to identify critically ill.
Clinical Risk Management.

12.  23% average deflection rate for ‘hear and treat’.
 30% deflection rate by the end of the financial
year.
 95% of Clinical Performance Indicators to be
met each month.
 5 Peer reviews each month.
 3 or more calls per hour.

13.  According to past, recent and current research
it is known that the positives outweigh the
negatives to secondary triage.
 It is essential patients are listened to and
directed to the best care possible.
 Care and compassion is what we are structured
on and safety of our patients is paramount.
 The use of MTS safeguards and is used as a
clinical risk management of the 52 presenting
complaints.

15.  Department of Health, Taking Healthcare to
the Patient 2, 2011
 Francis Report, 2013
 Keogh Report, Mortality Review 2013
 Nice Guidelines, Quality and productivity case
study, 2012
 Transforming urgent and emergency care
services in England, 2015