Table 1 Outline of the preliminary primary-care global trigger tool and trigger rationale
TriggerDescription and rationale for use
1. Timing of consultation>3 contacts with the practice in any given period of a week (this can include telephone calls, consultations with nurse/GP or home visits)
2. Place of consultationAny home visit, whether by the GP or by a nurse from the practice serves as a trigger
3. Frequency of consultation>10 consultations for the period of review (12 months)
4. Changes to medicationHas any “repeat medication” been added or cancelled in the period under review?
5. Adverse drug events/allergiesHas a new “read code” for allergy/adverse drug event been added to the record in the year under review?
6. New clinical read codeHas a high priority clinical “read code” been added to the record in the period under review?
7. Abnormal blood resultsSpecific abnormalities in U&E, LFT, INR and FBC levels served as a trigger
8. Out-of-hours and/or A&EAttendance at either of these services in the period under review served as a trigger
9. Hospital admission/dischargeHas the patient been admitted to a hospital for any intervention, management or procedure? The patient should have been admitted for at least one night
10. >1 outpatient appointments in last yearMore than one outpatient appointment or hospitalised as a day-case during the period under review
  • A&E, accident and emergency department; FBC, full blood count; GP, general practitioner; INR, international normalised ratio; LFT, liver function test; U&E, urea and electrolytes.