Over the past year, practices across our primary care network (PCN) have been on a significant journey exploring the role of online triage within general practice. Like many areas of the NHS, we have faced increasing patient demand, workforce pressures, and the ongoing challenge of ensuring that patients are seen by the right clinician, at the right time, in the right setting. Digital triage has increasingly emerged not simply as a technological change, but as part of a broader cultural shift in how modern primary care functions.
Our PCN digital lead has played an important role in helping facilitate this transition, supporting practices as they navigated the practical and organisational challenges involved in introducing new systems. Understandably, there was initial nervousness from staff. Any new IT system brings uncertainty, particularly in already stretched healthcare environments where teams are under constant operational pressure.
Questions were raised about workflow integration, patient accessibility, safety, and whether digital triage would genuinely improve patient care or simply create another administrative burden.
Alongside this, practices have also been adapting to rapidly expanding multidisciplinary teams. The introduction of additional roles reimbursement scheme (ARRS) staff has brought many benefits to primary care, including pharmacists, physician associates, and mental health practitioners. However, with larger and more varied teams comes the increasing need for effective navigation systems. Patients often still default to requesting a GP appointment, even when another member of the team may be better placed to help them more quickly and effectively.
This became an important focus of discussion within our PCN meetings. We spent considerable time exploring how ARRS roles could best be used and how systems could ensure that patients were directed to the most appropriate clinician first time. In many ways, online triage has helped support this process. By gathering relevant information at the outset, practices are often able to identify the most suitable professional earlier, improving both efficiency and patient experience.
Despite understandable concerns initially, feedback from both staff and patients has generally been very positive. Many patients value the flexibility and accessibility of submitting requests online, particularly those balancing work, caring responsibilities, or difficulties attending the surgery in person. Staff have also recognised benefits, particularly around workload management and prioritisation. Digital systems can help practices identify urgent problems more effectively, while also allowing more appropriate routing of routine or administrative requests.
That said, the transition has certainly not been without challenges. One recurring difficulty has been system integration. Many practices are now working across multiple digital platforms simultaneously, particularly where there are shared PCN appointments or services operating on secondary systems. At times this has created duplication, inefficiencies, and frustrations for staff attempting to coordinate care across different platforms that do not always communicate seamlessly with one another.
There are also wider considerations regarding the future direction of Integrated Neighbourhood Teams (INTs) and the evolving role of ARRS staff within them. As healthcare continues to move towards more collaborative, multidisciplinary community-based models, practices need reassurance that ARRS staff who have become embedded within PCN practices will not be transitioned entirely into INT structures. A further challenge remains the uncertainty surrounding the future of PCNs, with the current contract only confirmed until April 2027.
Ultimately, this journey has highlighted that digital triage is not simply about technology. At its core, it is about improving patient pathways and supporting staff to work more sustainably within an increasingly pressured NHS environment. While no system is perfect, there is a growing sense that, when implemented thoughtfully, online triage can contribute towards a model of care that is both better for patients and better for staff within our PCN — helping ensure that patients are managed appropriately first time, while allowing practices to use the full breadth of skills available across the wider primary care team.
Dr Matt Baines is clinical director at Coventry North PCN, West Midlands, and Pulse PCN board member,