Across the NHS, teams are grappling with unrelenting demand, workforce pressures, and rising patient expectations. Care navigation has been successfully implemented in primary care to help with this complexity. This approach – sometimes referred to as ‘signposting’, ‘triage’ or ‘digital triage’ – is designed to support a safer, more equitable and sustainable general practice.

Key principles of care navigation include handling all patient contact channels through a single workflow and assessing requests based on clinical need rather than first-come, first-served. These same principles are embedded in Gateway® to ensure every patient interaction is guided efficiently and effectively.

As NHS England embeds care navigation as best practice in primary care, we ask: Why are the same principles not embraced more widely across secondary and community care settings?

No – they’re not being ‘nosy’

When patients contact a GP practice, staff ask for additional information. This isn’t about prying; it’s about directing patients to the right professional or service first time. NHS England’s national training programme equips teams to gather this information safely and sensitively, using structured questions, clear protocols, and a deep understanding of local services.

Emphasis is placed on digital tools to support care navigation. This is where Gateway® delivers real impact. By integrating triage, workflow automation, and communication tools into one cohesive platform, Gateway® transforms care navigation from a manual, fragmented task into a streamlined, data-driven process. We empower staff to make faster, safer decisions and ensure patients are directed to the right care the first time.

A tale of two expectations

In general practice, care navigation is seen as innovation – an essential tool to manage demand. Our experience is that care navigation is seen as additional work in specialist and community services.

The difference is cultural and structural. Primary care has been empowered to rethink workflows, use digital triage, and deploy multidisciplinary teams. Secondary and community services, under intense operational pressure, often lack the time or infrastructure to implement navigation effectively.

Yet patients experience the NHS as a single system. From first contact with their GP to a consultant appointment or community clinic, they do not see silos. The disconnect between services is where the greatest inefficiencies and frustrations occur – and where our idea for Gateway® was first born.

Care navigation across the whole pathway

True care navigation isn’t just about moving patients through the front door faster – it’s about navigating them through the entire system. When care navigation principles extend beyond general practice, they reduce duplication, avoidable referrals, and waiting times, while freeing clinical capacity for complex cases.

Secondary and community services have a unique opportunity to adopt the same navigation mindset as primary care. With the right tools, teams can deliver faster, safer, and more coordinated care, benefiting both patients and staff.

Gateway®: enabling system-wide navigation

Gateway® was built to enable health systems to implement consistent, integrated care navigation across all levels.

• Workflow automation streamlines referral and triage processes, reducing administrative burden
• Integrated digital pathways connect general practice, community, and hospital teams in one shared view
• Data-driven insights provide clarity on demand, capacity, and patient flow across settings
• Learning and onboarding tools equip staff with the skills and confidence to navigate care efficiently

Local pathways can be built directly into the Gateway® system. Our team works alongside clinicians who define the service criteria that we then build into the system on their behalf. The result: patients reach the right care first time, teams spend less time on manual processes, and organisations gain actionable insight into their patient flow and capacity.

Gateway® doesn’t add work – it standardises access, reduces inefficiency, and improves patient experience across the NHS.

Reframe the narrative

It’s time to move beyond seeing care navigation as the ‘primary care fix’ and start recognising it as a whole-system enabler. With the right technology, processes, and training, care navigation becomes collaboration, not burden. When every team plays a role in guiding patients to the right care, we move closer to a truly integrated NHS – one that is sustainable for staff and responsive for patients.

A call to secondary and community care leaders

The benefits of care navigation shouldn’t stop at the GP surgery door. Secondary and community services can now access the tools, training, and support to implement system-wide care navigation efficiently. Connect with our team at Accenda and discover how Gateway® can transform care navigation in your organisation – improving patient experience and easing pressure on your teams.