An Overview of Out of Hours Benchmark

Using data to Improve Care: A new national benchmark for Out of Hours services

The Department of Health were keen to drive reliable comparisons of performance across out of hours services in England, building on the established national quality requirements, but breaking new ground in measuring outcomes as well as process.  Following a competitive tender, the Primary Care Foundation were appointed in November 2007 to develop a benchmark of out of hours services that would be seen as credible by commissioners and providers alike and would serve as a basis for service improvement.  The overall aim was to make accurate comparisons across different services so that providers and commissioners were in a position to recognise and take action to improve care for their patients.

The first round of the benchmark was completed in March 2009 by the Primary Care Foundation and involved 63 different services measured on a wide range of performance indicators, ranging from cost, to quality, outcomes, productivity and patient experience.  The second benchmark was completed in November 2009, involving 90 services and including a patient experience questionnaire returned by almost 10,000 recent service users across England, carried out by CFEP UK Surveys. The third benchmark, launched in November 2010, looked for the first time at peak demand for services during Christmas 2009 and New Year 2010, rather than ‘normal’ demand, focusing on a narrower series of performance measures.  The fourth benchmark again looked at performance across the full range of indicators, including patient experience and was completed in April 2012. For the first time, headline results were openly available on this website.

The benchmark is rigorous, being based on a sample data extract typically of several thousand cases, supplemented by web based questionnaires, as well as a specially commissioned patient experience survey.   All of this ensures that we are genuinely comparing ‘like with like’.

The benchmark has now been up and running for four years, and two thirds of commissioners across England made separate decisions to buy into this service. Commissioners understand that this type of information is the currency for effective commissioning of urgent care. There is already evidence that the benchmark is a powerful catalyst for action and there are good examples of how it has led to changes in the way services are delivered and significant improvements in patient care.

We are now looking at developing a new extended urgent care benchmark to support the new clinical commissioners as they hold the wider urgent and emergency care system to account.  More information will be available soon.

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.