The Challenges and Benefits

The Challenge for General Practice

Some practices have taken this work and have dramatically improved their management of same day and urgent care.  Many others have found that they need more support if they are to translate a better understanding of what they need to do into how they can take practical steps to make this happen.

Manually, developing a capacity plan is a time intensive activity, which tends to result in practices not undertaking the activity on a regular enough basis, if at all. 

Being online and, with an increasing number of practices taking part, practices will also be able to benchmark their own system and process against other local practices and those from further afield.


The benefits for General Practice

There are substantial patient benefits and benefits to practices.  There are obvious safety benefits if patients can get through to the practice by phone quickly, if receptionists are alert and trained to spot the signs of urgency and if the practice is able to respond quickly as necessary.  We described in the report a number of examples including one where small and single-handed practices had jointly commissioned a home-visiting service that ensured that patients could be seen promptly when previously too many of these cases would have resulted in an emergency response.  Whilst the service provided obvious benefits that were appreciated by patients by allowing a clinician to see them promptly at home, the GPs involved in commissioning it also described how it had made their life easier and allowed them to give a much better service to the patients who came to their surgery.

Before, during and since working on the report we have seen and advised a considerable number of practices and we have identified some key gaps in the ability of practices to undertake the basic work that would be required to implement the recommendations in the report effectively.


The Potential Impact on the Wider NHS

There are potentially significant gains if practices in each area manage urgent care effectively as we have seen reductions in acute admissions in some cases that are estimated as between 20 and 40% as a result of good management of urgent care in general practice.  Although this benefit will not be achievable in every case the aim of the work is to fill the gap in capability of practices to undertake regular and ongoing capacity planning to ensure their response to urgent care is as effective as possible.  The number of appointments in general practice is so large (300 million each year across England) that minute changes in the access and responsiveness can have a dramatic impact on secondary care.  It is because of this gearing effect that good General Practices that provide an accessible service to their patients deliver great benefits to the local health economy. 

There are also wider benefits as other partners in the wider health community, including Hospital Trusts and Ambulance Services, understand that commissioners are developing more comprehensive strategies for managing urgent and emergency care.  The all consuming focus on the key national standards for urgent and emergency care diverted attention away from a whole system solution, but has now been relaxed by the new coalition government.  General Practice is the first place where most people go with an urgent problem and, as we have demonstrated above, improving care as early as possible in the patient pathway is likely to have a significant impact on the stem as a whole. 

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.