New Opportunities

For Practices to audit their appointments and

For local health systems to shape their integrated urgent care system

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

Healthcare Leader Forum

Henry Clay will be speaking at the upcoming Healthcare Leader Forum: Improving urgent and emergency care conferences on 14th September at the Hilton Birmingham Metropole and also in Reading on the 21st September. This interactive conference will give its audience vital insight into the delivery of streamlined, efficient urgent care pathways emerging from regional transformation partnerships and local initiatives. Speakers will explore the necessary steps to ensure the audience know how to guarantee their organisation is fully prepared and that services are properly resourced.


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

A new 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


A new audit of potentially avoidable appointments in general practice – available to all practices at no cost

This audit was developed as part of our research for NHS England with the initial results - suggesting that 27% of GP appointments are potentially avoidable - published in ‘Making Time in General Practice’. NHS England are now committed to extending this work by funding support for practices - so there is no direct cost - of an App you can download on to your computer screen, making it really easy for you to see how many of your appointments might be avoidable and helping you explore how you might be able to do something about it. If you want to know more, download Frequently Asked Questions, the Governance Statement and the Application Form and take a quick look at a virtual tour or email us at This email address is being protected from spambots. You need JavaScript enabled to view it.


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.