What We Measure

Reports for each PCT contract with an out of hours provider include:

  • Case volume: Measured in cases per hour

  • Cost: Measured as cost per case and cost per head of registered population.  We also look at cost compared to ‘population density’ to look at the impact of a rural or urban seting.

  • Productivity:Measured in cases per clinician hour at the busy time at a weekend

  • Clinical governance: Because of doubts about the comparability of answers using the self-assessment process we recommend providers and PCTs jointly review what processes are appropriate locally.

  • Outcomes: looking at the levels of advice, base attendance and home visits as well as at referrals or self-referral to hospital. 

  • Performance: Against the standards for time to definitive clinical assessment and time to the face to face consultation

  • Patient experience: measured annually through questionnaires sent to recent users of all out of hours services

  • It is now clear that providers have been recording and reporting on data in different ways and the benchmark is encouraging greater consistency so that like for like comparisons can be made in all areas.

  • There is now widespread acceptance of our approach which is seen as far more rigorous than previous exercises by the National Audit Office and the Healthcare Commission. It also offers a clear basis for making credible comparisons across organisations and, as the benchmark progresses, over time.

  • Over 100 PCTs have now bought into this service, nearly all of them for three years, exceeding DH targets.  As membership increases, the strength and credibility of the benchmark is enhanced.

We have emphasised that on many of these performance measures there is no simple way of identifying what is good or bad.  Rather than taking one measure in isolation, we encourage providers and commissioners to take all of the measures together as a rounded picture of overall performance.  Crucially, it enables services to focus on areas of comparative weakness and explore further, often looking at the even wider variation of the performance of hundreds of individual doctors, nurses and other clinicians,  that underpins organisational variation.

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.