New Opportunities

For Practices to audit their appointments and

For local health systems to shape their integrated urgent care system

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

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.