Overview: Extended Primary Care

The developing role of primary care, built around general practice, is at the heart of transforming the delivery of healthcare in the UK.  The Primary Care Foundation is increasingly working with groups of practices and across CCGs to explore how practices might work together.

Recently we worked with three sites across London through the London Office of CCGs to develop practice federations, as well as running events and developing longer-term support for other areas across the Country.

We encourage practices to think through carefully the purpose of working together rather than simply being driven by national policy or local pressure.  There are real strengths in the traditional model, built on continuity of care with small practices responding rapidly to changing needs.  Practices often need to learn more about each other and how they are working now before thinking about what they might do in the future. 

But in a climate of financial austerity more practices are finding it difficult to balance their budgets while, at the same time, the expectations of both patients and the healthcare system continue to increase.  Practices are looking to work together on a wide range of issues including:

  • Shared back office functions and joint purchasing
  • Sharing clinical expertise across a wider group of practices
  • Introducing access to extended hours in a co-ordinated way
  • Responding to tenders from local commissioners for current services (LESs) or new service developments
  • Shared training and education for all staff in general practice
  • Implementing common information systems so that patient notes can be accessed across all practices and, potentially, the wider health and social care system
  • A shared approach to supporting frail elderly people with complex health needs
  • Creating integrated primary care teams that connect general practice, community services, community pharmacy and third sector agencies

We also can offer support to think through the organisational and governance issues of working together.  We always encourage practices to think through the purpose and function before the organisational form, but understanding all the advice and support they need and establishing effective and transparent decision-making processes is important.

If you would like to discuss how we might help your practices work together, or develop extended primary care in your area, please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it. or call Rick Stern on 07709 746771 or David Carson on 07703 025775.


About Us

The Primary Care Foundation was established to support the development of best practice in primary and urgent care.  The three Directors bring different skills and perspectives to understanding primary and urgent health care - for more details click below:

David Carson

Rick Stern

Henry Clay



Latest News

New on-line registration for the potentially avoidable appointments audit

The Primary Care Foundation were selected by NHS England to further improve and automate the audit of potentially avoidable appointments. We are now building a new website with Method Analytics that will make it much easier for any practice to register online, will simplify data collection for clinicians, and will allow for instant reporting on results. The reports will be much easier to understand and will signpost other support. And it will remain free to use for all practices in England.

We are now ready to go live with a new ‘test’ site. We are confident it is already easier to use but we are keen to get any feedback from practices before the new website is fully up and running.

If you are a practice in England and you want to register, CLICK HERE  and click on ‘register here to create a practice audit!’ You will be guided through registration and how to set up your clinicians to take part in the audit.  This is a new test site, so if you notice anything that doesn’t look right, or could be made easier, just let us know.  And the same for your clinicians as they enter data – any feedback at the moment – good or bad – would be really helpful … just email us This email address is being protected from spambots. You need JavaScript enabled to view it.


What do we mean by an ‘avoidable appointment?

The latest blog by Rick Stern ‘If only …’ explores the idea of avoidable appointments, what practices have gained from the audit, and what might be possible with further investment in general practice. It is available HERE and will also be published in Health Care Leader.


Are there any simple lessons for practices looking to improve access?

A feature article in Management in Practice by Rick Stern reviews what we have learned from working with over 1,500 practices across the UK – you can read the full article HERE  


Integrated Urgent Care – how to make NHS 111 work

A lead article for Health Care Leader by Henry Clay describes a financial and capacity model developed for NHS England, the potential benefits and pitfalls, and what we have learned from working with a dozen areas to apply the model. The article is available at HERE and a fuller version with a number of explanatory graphs can be downloaded HERE


Integrated Urgent Care – opportunity for support to your locality

We have developed a financial model for the Integrated Urgent Care Team at NHS England that focuses on the NHS 111 and OOH ‘front end’ to an integrated urgent care system (but also looks at the cost of onward referrals to other services). This is proving to be an invaluable tool for both commissioners and providers. It is now available to use and NHS England have also agreed to support some sites to setup and work through the model with PCF’s Henry Clay who developed the model. For further information please contact Henry on This email address is being protected from spambots. You need JavaScript enabled to view it.


We are now supporting over 1,500 practices across the UK to manage access and urgent care

Our support for general practices looking to improve access for patients and streamline the management of urgent care continues to expand. Based on a web based tool, developed out of our work commissioned by the Department of Health, we collect practice data for one week and prepare a report for each practice looking at how you compare to others and explore what this means for making practical changes in the way you work. We are regularly improving the format of our reports for practices based on constant feedback. If you would like to see an example report, CLICK HERE.  If you want to know more about how we might work with you please contact Rick Stern on  This email address is being protected from spambots. You need JavaScript enabled to view it.  or call on 07709 746771.