Primary care triaging guidance published in BJGP

The British Society of Echocardiography (BSE) is delighted to announce the publication of guidance on primary care triaging for echocardiography in the British Journal of General Practice (BJGP).

One of the biggest challenges facing echo services now is the size of waiting lists following the pandemic. The BSE believes that accurate triaging is the best way to ensure that services can meet the needs of patients. Earlier this year we were invited by NHS England to produce guidance to facilitate the effective triage of backlog requests for echocardiography. The Society had produced similar guidance previously and was happy to review and renew our resources.

The subsequently produced echo triage guidance documents cover all anticipated areas from where requests may arise: emergency, in-patient and out-patient (primary and secondary care). Where available NICE guidance has been referenced. However, by definition, the group of patients included does not have a diagnosis but merely a collection of clinical symptoms and signs. The resulting heterogeneous nature of the patients covered by this guidance, combined with the varied medical professionals that refer, meant that an underpinning reference base to draw from was lacking and instead the more subjective use of consensus expert opinion was employed. Accordingly, the documents were produced from gauging a broad range of opinions from clinicians in a wide variety of clinical practice settings. These included very experienced authors with primary, secondary and tertiary care experience. This approach is not an uncommon compromise to reach in this situation as the complexity of achieving a supporting evidence base in diagnostic testing has historically led to a 'best practice' approach to clinical guidance.

Dr Andrew Potter, GP Representative to the Society and GP at Whaddon Healthcare, Milton Keynes, said "The primary care triaging poster is a helpful document for primary care. It can support GPs in difficult decisions on when an echo might not be helpful in some patients and reduce unnecessary echo requests. We have published the poster in this month's British Journal of General Practice to help it reach as many GPs as possible."

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