New Opportunities

For Practices to audit their appointments and

For local health systems to shape their integrated urgent care system

Who We Are

The three Directors bring together complimentary and different perspectives of the delivery of health care. The following sections give more details of each Director.


Dr David Carson

Dr Carson was a GP for 10 years before spending 6 years in an inner London Health Authority leading primary care policy and performance.  Whilst there he led a service and strategy review of primary and acute services resulting in the delivery of £13M of savings, much of it through de-commissioning services and commissioning a rather different range of services.  He also developed and implemented performance management systems for general practice in East London and led an educational project within which joint training and development structures for doctors and nurses were developed compliant with multi-professional regulatory frameworks.

David spent 4 years developing GP Out of Hours services and emergency care policy and performance for the Department of Health.  During this time he published – 'Raising Standards for Patients: New Partnerships in Out-of-Hours Care' (known as the ‘Carson Report).  David was also the primary care lead on the development of ‘Reforming   Emergency Care’.

The ‘Carson Report’, for which David is probably best known, defined the way ahead and set the standard - embodying integrated services and co-operative staff working as core principles as well as introducing new thinking and new approaches to unscheduled care into the Healthcare community.  He was also part of a performance team from the Department that looked at well over 50 NHS Trusts looking at how they operated within their local health economies.

More recently David has also acted as an adviser to the National Audit Office, the Healthcare Commission and the Care Quality Commission in a number of high profile reviews that these bodies have carried out.  He has also looked at other health economies including those in Australia (primary care), Italy (accreditation) and Scandinavia and Holland (urgent primary care).


Henry Clay

After a background in manufacturing organisations including roles as operational manager, accountant and general manager, Henry has spent some 20 years as a consultant to organisations in both the private and public sector.  Much of this work has involved the specification and commissioning of a range of public sector services from benefits, through support services including (for the NAO) a review of the way in which IT services were outsourced by the Inland Revenue to primary and secondary healthcare services.  He has advised the Care Quality Commission and the Healthcare Commission not just on their investigations into specific cases (such as the investigation into Take Care Now) but also in their wider evaluations of value for money (such as the report 'Not just a matter of time' into GP out of hours services).  A particular interest is in making sure that the data collected through systems is useable and used to support improvement of the service.

Work within the acute healthcare sector has involved him in A&E, Urgent Care services of all types, Diagnostics and Pathology, IT systems , Imaging, Medical assessment as well as in Health Insurance.  In Primary Care, Henry has worked with many Out of Hours providers, particularly in benchmarking their performance and looked at the operation of numerous general practices, Walk in Centres and Minor Injury Units.  He has also worked with Practice Based Commissioning groups looking to specify services, groups of GPs forming provider service organisations and in looking at mutual and social enterprise models of provider.


Rick Stern

Rick works full-time for the Primary Care Foundation. From April 2012 until January 2016 Rick split his time between the Primary Care Foundation and the role of Chief Executive at the NHS Alliance, where he was responsible for extending its role as the voice of primary care providers. This involved influencing the direction of national policy on primary care as outlined in ‘Breaking Boundaries’, its manifesto for primary care launched in March 2013 and ‘Think Big, Act Now: creating a Community of Care’ in October 2014, a forerunner to the Five Year Forward View. More recently he worked across both organisations to develop ‘Making Time in General Practice’ working closely with NHS England and other leading primary care organisations to look at reducing the workload on general practice.

Rick was previously the Chief Executive of Bexhill & Rother PCT until the end of July 2005 where he led a national pilot to develop out-of-hours services and was the lead Chief Executive for the South East within NatPaCT, the national PCT development programme. It was the only PCT in the South East to receive a 3-star award when the new ratings were introduced in 2003 and it consistently featured in the top 10 PCTs in the annual staff survey.

Rick has worked across a range of sectors and in a variety of roles, including general management, internal consultancy, research and face-to-face with vulnerable clients. He led Access to Health, a Kings Fund initiative in the early 90’s to improve health care for homeless people, was responsible for developing quality standards in a mental health and community trust in Inner London and for developing commissioning within a regional health authority. He is also a practicing psychodynamic counsellor.

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.