Single Point of Access: Senior Clinician at Triage Point

Introduction 

The Integrated Care Coordination (iCC) triages calls pre-ambulance dispatch. Patients not meeting urgent care response (UCR) pathways are declined and ambulances are dispatched. We implemented a senior clinician rota, allowing the iCC to discuss these patients with a senior decision-maker and employ the most appropriate service. This ran from 6th to 30th January 2026, Monday to Friday, 8am to 8pm for patients aged over 65 years registered with a Warwickshire GP. The aim was to reduce pressure on emergency services by managing patients safely in the community.

Methods 

Senior clinicians at South Warwickshire Foundation Trust discussed patients with the iCC. From these discussions, data was collected on the date/time of initial call, referrer source, clinical history, initial and 1 week outcomes, and phone wait and talk times. Data was verified through consultant connect. 

Results 

145 patients were discussed and 45.5% were diverted from ambulance dispatch initially. Of these, 87.9% were allocated to UCR and 10.6% to General Practice (GP) for review, with 73.8% managed in the community. Within 8 days, 10.8% were admitted to hospital. Same day emergency care (SDEC) was not utilised initially or by UCR but was used following GP or Emergency Department (ED) assessment. Of those admitted, 34.4% were discharged the same day from ED or SDEC.

Average talk time between triaging and senior clinician was 3:22minutes, totalling 8:37 hours of senior clinician time and 49:58 hours of total triage team time.

Conclusions

Ambulance conveyance to hospital was reduced, with a significant shift towards community services, although clinician and total triage time increased. Admission avoidance was not simply delayed admission, with most patients remaining at home at 1 week. Further analysis is needed to determine whether cost savings outweigh implementation costs and whether community and SDEC services can meet increased demand.