Case Study: St Andrews

A ‘revolutionary’ triage system at
St Andrews Health Centre

Before 2022, the triage system at St Andrews Health Centre routinely left staff stressed, patients frustrated and capacity low.
But after moving to total triage, the team now resolve 99% of patient requests within 48 hours, improving access and taking greater control of the 8am rush.
Discover total triage

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

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 with patient requests, which came in by phone, online and in person and without an effective system of inbound management.
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”.

How total triage works at St Andrews today

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.

The patient completes the request – or goes through the form with a receptionist if they’re unable to themself.

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 GP lets the patient Self-Book an appointment if one is needed, which can be delivered by phone, video or in-person.

Inspired by St Andrews?

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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


  • Patients no longer have to join the 8am rush and improved access routes. They can contact the practice via a simple link, confident that they’ll receive a reply the same day.
  • Receptionists can enjoy a less pressured work life and better morale. As well as improving efficiency, the new system has also empowered the team to upskill and improve triaging decisions.
  • Fewer patient complaints, with more timely resolution of patient requests.
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

Connect with total triage practices

Join our Patient Triage group on Facebook to connect with practices running total triage for useful guidance and tips.
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When we got Accurx, it [the triage process] got so much easier. Patients love the system. It's quicker – they don't have to wait around. I'd tell all the other surgeries to get it – 100%. Before this, we had phone calls coming in non-stop. It's still busy but it's calmed down a lot.'

Jay, PA, St Andrews Surgery