Responding to Omicron - Triage 

1 February 2022 

Dr Bryan Betty, College Medical Director
Dr Peter Moodie, College Clinical Advisor

Over the coming weeks, we’ll be writing a series on different practical issues that general practitioners might experience with the advent of the Omicron pandemic.

These articles are not designed to solve problems but rather to identify where problems might arise and then create a debate about how they might best be solved.  We invite constructive solutions to the problems, with a “general practice managing general practice” lens applied.

The reality is that the most efficient source of advice even for those with mild illness is a primary care clinician with the patient’s case notes in front of them, with the bonus of actually knowing the patient. A truly potent combination.

These articles should be read in conjunction with the College’s patient management in the traffic light system document.

Phone triage
With the impending rise in Omicron cases, we need to think of ways to pre-emptively reduce unnecessary calls into general practice.  At a national level, plans include advertising campaigns to encourage patients to self-manage and avoid involving general practice unless required. 

While this sounds like a good idea, patients will still gravitate to services they trust and that is likely to be general practice. 

Also, there are many people who may not have access to electronic services and will access services physically. General Practice needs to be prepared for both of these scenarios and if other agencies become over run we anticipate that there will be a surge in phone calls. 

Possible mitigation could include:

  • Increasing the number of staff managing phone lines, either by redeploying or considering short-term hiring of staff.  We are discussing how this could be supported with the MoH.
  • Prioritise portal use and increasing the number of staff responding to portal questions should also be considered.
  • Adjusting the message for patients while they are on “hold”.  Careful consideration of messages, bearing in mind the frustrations we have all encountered while waiting for a call to be answered.  These might include:
    1. Direct those with mild symptoms to self-help websites.
    2. Direct people to a specific COVID-19 line and ensure triage and care services are focused on those who are at high risk.
    3. Explain they can send their question via the portal which will be answered within a specified time.
    4. Set up a note or keyword that identifies the COVID-19 plan for each high-risk person – who is at home with them, who is their support, have they got their medications, what is the best form of contact?

Any messages sent should be relevant, helpful, and to the point. It is, however, important to make sure that those needing to get through can talk to an appropriate clinician within the practice.  Again this may mean an increase in clinical staff dealing with telehealth.

For those practices using portals the advantages are that time pressure is reduced and form messages can be sent.  It is also a useful way of maintaining contact throughout an illness.

Portals also offer an opportunity to proactively contact patients and tell them what to expect and how to self-manage.  

However, there will be patients who have difficulties accessing portals due to technical ability or no computer/Wi-Fi so identifying alternative ways to contact them and proactively planning with your high-risk patients will also save time and pressure on the practice in the long run.

We welcome feedback and will incorporate that into a further article.