Case study:

St Andrews Health Centre

Building a ‘revolutionary’ triage system to improve access and speed up care

Before 2022, long queues would form every morning outside of St Andrews Health Centre. At the time, patients were frustrated and staff were stressed.
So the practice stepped back to build what’s now a leading system of total triage – a system that resolves 99% of patient requests within 48 hours.
Get started with total triage

Impact at a glance:

99% of patient 
requests are resolved 
within 48 hours

Average response time 
of just 30 minutes for 
patient requests

1,569 appointments 
booked with Self-Book 
(April-Oct 2023)

Context: held back by the 8am rush

St Andrews Health Centre covers an ethnically diverse population of 16,000 patients in London. In early 2022, staff were overwhelmed and had no clear system for managing patient requests, which came in by phone, online and in person.
The team offered all the appointments they could and asked any patients who weren’t given an appointment to call back the next day. This resulted in long queues – both on phone lines to reception and outside the practice. GP Partner, Dr Osman Bhatti, described the situation as “a mess that wasn’t good for us or our patients”.

We used to have a hundred-yard queue outside the surgery at about eight o'clock in the morning. It was like Glastonbury tickets – all appointments were gone within an hour. Patients got fed up with waiting on the phone. The triage and booking system didn’t work well.

Dr Selvaseelan Selvarajah, St Andrews Health Centre

After reviewing their ways of working, the practice decided to
make the move to total triage.

In early 2022, teams across the practice came together to evaluate the pinch points and shortcomings of their triage system. Collaboratively, they mapped out a new patient pathway to streamline the way demand comes into – and is managed – by the practice. They took time to train their staff, obtain feedback and communicate the change in system to patients.

Here’s how patient requests come into the practice today


A patient gets in touch with the practice in-person, over the phone or online.


A patient gets in touch with the practice in-person, over the phone or online.


The patient is asked to submit a Patient Triage form using a URL link, if they haven’t already.


All patient requests flow into one triaging inbox with shared visibility for the whole team.


The reception team assign requests to GPs, pharmacists and other clinicians with the guidance of the triage doctor.

The team use Accurx’s full toolkit to manage patient requests

Patient Triage and Reception Flow let the practice funnel all requests into one inbox, ready for the team to action

Staff can send SMS messages and patient questionnaires to collect data, monitor conditions and meet needs remotely

Accumail lets staff communicate quickly and easily with other NHS services, without system hopping

With Self-Book, staff can instantly send patients booking links to take the time out of appointment booking

Thinking to redesigning your triage process?

Find out how you can move to a total triage model with Accurx.

Start your total triage journey
Dr Selvarajah trains local practice staff on total triage.

‘We can get through about 200 to 300 patient queries in a day.'

Need some pointers to roll out total triage at your practice? See Dr Selvarajah’s learnings and guidance.
Read Dr Selvarajah’s blog

What impact has total triage had for the practice?

Today, patients no longer have to join the 8am rush. Instead, they can contact the practice via a simple link, confident that they’ll receive a reply the same day. Meanwhile, the number of patient complaints has fallen and receptionists are enjoying a less pressured work life with better morale. Having been upskilled through this stream of work, staff also feel like more of a cohesive team across the practice.

Between April and October 2023...

99% of patient requests

were resolved within 48 hours, with an average response time of 30 minutes

1,569 appointments

were booked in with Self-Book

1,860 questionnaires

were completed by patients, giving the team vital information

2,004 messages

were sent to NHS professionals outside the practice via Accumail

Inspired by St Andrews?

Find out how you can move to a total triage model with Accurx.

Get started with total triage

The results are in...

In September 2023, we listened to 373 GP practice staff through our research, which revealed the outsized impact that Modern General Practice Access has.

75% of GP practice staff

believe they are now providing a more equitable service

81% of practices

feel they are now better equipped to keep up with inbound patient demand

65% of practices

said that patients are more satisfied with their service

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