COVID19: QI From the Frontline 25th March, 2020

Dr Christopher Magier, Consultant Paediatrician at Isle of Wight NHS Trust, shares a system of 'double triage' to manage incoming GP referrals.

By meganpeng · March 25, 2020

Double Triage

While the face to face paediatric clinics are cancelled, we introduced “double triage”.

A consultant on-call triages incoming GP referrals to decide which referral can wait till August or September.

  • ​We use the system accepted by our hospital of allocating grades of urgency: 1, 2 or 3.
  • In the comments we’ll write for example; “routine, grade 2” and so on.
  • After resuming normal activity, number 1 will be allocated an appointment first.

Referrals marked “urgent” will be allocated to paediatric consultants to deal with in their “virtual clinic”.

  • They will be owning the case and deciding what to do with them.
  • I’d suggest to do paper printouts and case notes that can be picked up from pigeon hole by somebody else in case of sickness.

The consultant paediatrician will then contact the family and decide what is needed, making a record in the notes.

  • If physical examination or blood test is needed it will be arranged individually by appointment.
  • If after “enhanced triage” they decide it can wait till resuming of normal activity, they will grade it 1, 2 or 3 and pass to OPD clerks with letter dictated.

This way of managing new referrals should keep the system safe.


Dr Christopher Magier

Consultant Paediatrician at Isle of Wight NHS Trust