The NaRT tool has been designed specifically for use within the Nursing and Residential Home setting by both nursing and care home staff. It is based on the Manchester Triage System (MTS) and is designed to integrate with a series of tools in other domains which are all based on the same system:  

  • Emergency Triage: Emergency departments  
  • Telephone Triage and Advice: Urgent care desks 
  • Pathfinder: Paramedic ambulances 
  • SAFE pathways: Community-based HCPs 

The 5 triage tools all share:  

  • A reductive methodology identifying life threatening illnesses and injuries first 
  • A clinical risk management tool used Worldwide to safely manage patient flow when clinical demand exceeds capacity  
  • A common set of discriminators defined in a discriminator dictionary  
  • A shared language and common understanding 
  • Underpinning training packages and e-learning modules for practitioners 
  • A method of streaming for local implementation


The principles of the Manchester Triage System are still followed with the use of the reductive methodology, however rather than choosing between 53 MTS presentational charts, the Nursing and Residential Triage tool comprises of just two charts; Illness and Injury. 

Some discriminators and definitions have also been amended to enable both nurses and residential care workers to use the tool. Using the NaRT tool does not require a clinical decision to be made, rather it asks the person making the assessment to make their way through a list of presenting symptoms and, where the patient displays any of the symptoms on the list, the outcome should be followed. 

 Outcomes can be tailored to the availability of services in your area but in general the following services (or equivalent) would be required:

  •  Ambulance service Clinical Hub, Single Point of Access or other locally agreed urgent care providers for amber outcomes 
  •  GP, OOH GP or District Nurse available for green outcomes

In order to implement the Nursing and Residential tool, homes must sign an MOU to say that they are prepared to provide at least two key instructors who will attend an initial NaRT Instructor training session, who will then be responsible for cascading and managing the training within their Home, and that they will engage with audit requirements for the tool. 

There is also a small licencing fee per home to cover the registration of the Homes, maintenance of training materials and supporting documentation and the ongoing support of the Manchester Triage Group.  

Further information on setting up for the first time can be found here

Last modified: Wednesday, 24 February 2021, 11:59 AM