RT Journal Article
SR Electronic
T1 Impact of Advanced Access on access, workload, and continuity: controlled before-and-after and simulated-patient study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 608
OP 614
VO 57
IS 541
A1 Chris Salisbury
A1 Alan A Montgomery
A1 Lucy Simons
A1 Fiona Sampson
A1 Sarah Edwards
A1 Helen Baxter
A1 Stephen Goodall
A1 Helen Smith
A1 Val Lattimer
A1 D Mark Pickin
YR 2007
UL http://bjgp.org/content/57/541/608.abstract
AB Background Case studies from the US suggest that Advanced Access appointment systems lead to shorter delays for appointments, reduced workload, and increased continuity of care.Aim To determine whether implementation of Advanced Access in general practice is associated with the above benefits in the UK.Design of study Controlled before-and-after and simulated-patient study.Setting Twenty-four practices that had implemented Advanced Access and 24 that had not.Method Anonymous telephone calls were made monthly to request an appointment. Numbers of appointments and patients consulting were calculated from practice records. Continuity was determined from anonymised patient records.Results The wait for an appointment with any doctor was slightly shorter at Advanced Access practices than control practices (mean 1.00 day and 1.87 days respectively, adjusted difference −0.75; 95% confidence interval [CI] = −1.51 to 0.004 days). Advanced Access practices met the NHS Plan 48-hour access target on 71% of occasions and control practices on 60% of occasions (adjusted odds ratio 1.61; 95% CI = 0.78 to 3.31; P = 0.200). The number of appointments offered, and patients seen, increased at both Advanced Access and control practices over the period studied, with no evidence of differences between them. There was no difference between Advanced Access and control practices in continuity of care (adjusted difference 0.003; 95% CI = −0.07 to 0.07).Conclusion Advanced Access practices provided slightly shorter waits for an appointment compared with control practices, but performance against NHS access targets was considerably poorer than officially reported for both types of practice. Advanced Access practices did not have reduced workload or increased continuity of care.