The triage step in personalised care and support planning (PCSP) is particularly important when practices implement the approach for people with multiple long-term conditions and complexity. We sometimes refer to this as ‘professional preparation’ ahead of the PCSP conversation appointment.
For most patients this will take only 2-3 minutes, but patients with more complexity may merit additional team discussion to aid learning and provide supervision to staff who are new to practice or are increasing the range of conditions they are confident to review.
Triage has several potential functions depending on the skill mix and experience of the practitioners who are involved in PCSP conversations. These include:
- Noting any early patient concerns raised with the HCA at the information gathering review (and any other important information in the clinical record such as referral to or information from specialists)
- Reviewing test results and information gathered to identify any red flags and any urgent issues that need to be dealt with, including organising any further tests to be completed ahead of the PCSP review
- Identifying if it is likely that medication may need to be stopped/started or modified as part of the PCSP process and considering which practitioner might have the skills to include medication reviews if needed
- Ensuring the patient is given an appropriate PCSP appointment with a practitioner who knows them (continuity) or/and can support them with the clinical and non-clinical issues that have been identified as part of information gathering
- Ensuring the patient is given an appointment of appropriate duration and in a format that works for them (telephone/video/face to face)
Some practical considerations when implementing the triage step are:
- Who will do this and what is your approach to knowing which practitioner should do the PCSP appointment?
- How will blood test results relevant to PCSP come back to the practice and who will review the results? This will ensure they aren’t filed and actioned alongside blood tests being carried out to support other types of appointment (some practices create a generic inbox for the return of results or note YOC review on the blood request form)
- How are test results going to be checked i.e. who checks them, what happens if a result needs attention prior to the PCSP conversation, what is the process when tests need to be repeated, and how do you avoid them being actioned by GPs?
- How will you task the administration team to produce the patient preparation letter and the appropriate appointment?