Total Triage – What is PSM Medical Group’s Total Triage System

From Thursday, 15th October 2026 PSM Medical Group will be operating a Total Triage service.

The PSM Medical Group Triage System was developed by our GPs to facilitate more efficient handling of the ever rising demand for primary care appointments. The system uses Patient Triage supplied by AccuRx as the online patient communication platform and relies on the triaging skills of experienced GPs to prioritise resources according to clinical need as well as signpost patients towards the most appropriate services.

This system has also enabled the practice to work toward implementing the BMA’s Safe working in General Practice guidance to ensure Primary Care teams provide patient appointments more flexibly, direct patients to the most appropriate provider of care and prioritise care for those most in need. You can use the system to operate a waiting list safety for primary care.

Because all requests are considered upon clinical urgency by a GP, this does mean that patients will no longer be able to directly book a GP or Advanced Clinical Practitioner appointment over the phone or at the reception desk. All patients will be asked to complete a triage form online, or those who do not have online access can speak with one of our Care Navigation team and they will complete and submit the form for you.

Using Total Triage to Implement Safe Working in General Practice

The video below describes how The PSM Medical Group’s Triage System of risk stratifying appointments can be used to operate in NHS Primary Care in a safe manner and also help practices to achieve the recommendations outlined in the BMA’s Safe Working Guidance in General Practice.

How it works

Patient submits an online submission using a simple online form

• We have tried numerous online consulting platforms and have settled with AccuRx’s Patient Triage solution because out patients prefer its simplicity and the ease with which submissions can be made to the surgery.
• We also found that the system integrated with our clinical system (EMIS Web) much better than other systems and with less chance of error.
• The system is fast, smooth and reliable with minimal downtime and excellent user support.
• Admin staff and triaging clinicians also prefer the intuitive user interface and the ease with which submissions can be read and acted upon.

• • Whichever online system you choose to use, it is important that practices are able to switch off the ability for patients to submit a form especially during evenings, weekends and bank-holidays. Our conclusion has been that demand in the NHS is actually unlimited and NHS healthcare is essentially rationed. Traditionally the mechanism of rationing was via wait times on telephones and in queues at GP reception. This method of rationing and limiting demand is bypassed by online patient submission platforms and threatens to overwhelm already limited primary care resources so mechanisms to switch off online submissions during non-working hours are essential.
  • Those patients genuinely incapable of using the online form are still able to call the surgery to access care. Receptionists (Care Navigators) complete the online form for the patient and the request is triaged along with other forms submitted by online users. AccuRx Patient Triage allows Care Navigators to submit such forms on patient’s behalf very easily into the main triage workflow.

Patient submission enters the Triage Workflow

• All online submissions enter the “To Assign” inbox of the AccuRx Patient Triage system
• The “To Assign” inbox has two subfolders; “Admin Queries” and “Medical Requests”.
• A Care Navigator checks the submissions in the “Admin Queries” inbox and forwards these to the appropriate teams within the practice. The “Medical Requests” are first seen by a GP or Advanced Clinical Practitioner and a clinical decision is made on what happens with that request. Our Care Navigation team then action those “Medical Requests” and liaise with the patient.

Submissions are triaged by a Clinician

• We have found that triaging is best done by experienced GPs. Whilst this takes away a GP from a booked surgery list, we have found that slots are triaged and dealt with much more efficiently and wait times for appointments have actually decreased from what they used to be before we implemented this system.
• On-call clinicians cover either the morning or the afternoon session. Our morning session runs between 8AM and 1PM. Our afternoon session runs between 1PM and 6:30PM. We are considering having two triaging clinicians on Monday & Tuesday’s as demand is so high during this period.
• AccuRx Patient Triage allows the Triaging Clinician to request further information directly from the patient who has submitted a request. Requests can also be made for photographs or copies of any relevant documentation.
• The on-call clinician diverts some requests as appropriate to other locally commissioned services such as First Contact Physiotherapists, Community Pharmacists, Care Navigators, etc.

RAG Rating

• The Triaging Clinician categorises requests requiring primary care appointments into Red, Amber and Green appointments.
• Patients requiring Red appointments are offered an appointment that day.
• Amber Appointment slots are to be offered an appointment within 7 days.
• Green Appointment slots are for those patients whose needs can wait a little longer, but will generally be offered an appointment within 2 weeks.
• RAG rating requests for care needs careful preparation and thought. We are tweaking our appointments and the proportions of each type of appointment constantly, often resulting in wait times for green appointments increasing. This way of triaging does however ensure that care is prioritised according to clinical need more safely.