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An evaluation of advanced access in general practice

Salisbury, Chris, Banks, Jon, Goodall, Stephen, Baxter, Helen, Montgomery, Alan, Pope, Catherine, Gerard, Karen, Simons, Lucy, Lattimer, Val, Sampson, Fiona, Pickin, Mark, Edwards, Sarah, Smith, Helen and Boudioni, Markella (2007) An evaluation of advanced access in general practice National Co-ordinating Centre for NHS Service Delivery and Organisation

Record type: Article


Aims: To evaluate ‘Advanced Access’ in general practice, and assess its impact on patients, practice organisation, activity, and staff.
Objectives: To describe the range of strategies that general practices have employed to improve access to care To determine the impact of Advanced Access on the wait for an appointment, continuity of care, practice workload, and demand on other NHS services. To explore the perceptions of different groups of patients, including both users and non-users of services, about the accessibility of care and their satisfaction with access to care in relation to different models of organisation. To explore the trade-offs that patients make between speed of access, continuity of care and other factors when making an appointment in general practice. To explore the perceptions of general practitioners and receptionists about working with the NPDT and implementing changes to practice arrangements to improve access. To assess the impact of the above changes in practice organisation on staff job satisfaction and team climate.
Method and results: This research was based on a comparison of 48 general practices, half of which operated Advanced Access appointment systems and half of which did not (designated ‘control’ practices). These practices were recruited from 12 representative Primary Care Trusts (PCTs). From within these 48 practices, eight (four Advanced Access and four control) were selected for in-depth case study using an ethnographic approach. The research was comprised of several component studies. These included: • A survey of all practices in 12 PCTs. Based on this we recruited the 24 Advanced Access and 24 control practices and the 8 case study practices. • An assessment of appointments available and patients seen, based on appointments records • An assessment of continuity of care based on patients’ records • Random phone calls to practices to assess ability to make an appointment by telephone • A questionnaire survey of patients attending the practices • A postal survey of patients who had not attended the surgery in the previous 12 months • A discrete choice experiment to explore trade-offs patients make between access and other factors • A survey of practice staff • Qualitative case studies in 8 practices • Interviews with PCT access facilitators The methods and results for each of these studies are described below, in relation to each of the research objectives.

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Published date: 15 February 2007
Additional Information: This report describes a research study into how GP appointments are organised, particularly the use of the 'Advanced Access' method of improving access to appointments. The study compared practices that used 'Advanced Access' with others that did not. The researchers assessed the impact on patients, practices and practice staff.


Local EPrints ID: 67203
PURE UUID: ba3e7809-3113-4c76-803b-7c36345bb554
ORCID for Catherine Pope: ORCID iD

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Date deposited: 10 Aug 2009
Last modified: 19 Jul 2017 00:20

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Author: Chris Salisbury
Author: Jon Banks
Author: Stephen Goodall
Author: Helen Baxter
Author: Alan Montgomery
Author: Catherine Pope ORCID iD
Author: Karen Gerard
Author: Lucy Simons
Author: Val Lattimer
Author: Fiona Sampson
Author: Mark Pickin
Author: Sarah Edwards
Author: Helen Smith
Author: Markella Boudioni

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