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ADVANCED ACCESS IN PRIMARY CARE
by
Dr John Oldham
John Oldham 2001
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Preface
I would like to thank the National Primary Care Development Team for their help in
preparing this booklet. Also, Mark Hunt, John Bibby and Tim Wilson for their scrutiny of
the text. Most of all I wish to express my gratitude for the energy and hard work of the
practices on the Primary Care Collaborative and those who generously donated their
stories, without whose experience this booklet would not be possible.
The origin of the principles on advanced access owes much to the pioneering work of my
friend Mark Murray. I have known Mark for a number of years, from when he was a
physician in Sacramento, California to his current role as international consultant (Murray,
Tantau and Associates, murraytant@email.msn.com). There are only a few individuals in
our lives who develop concepts that are globally applicable; Mark is one of those rare and
talented people - and a great guy!
John Oldham January 2001
Head of National Primary Care
Development Team
Gateway House
Piccadilly South
Manchester M60 7LP
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This booklet is intended to provide a guide on how to improve access to primary care for
the patients of a practice. To do this, various examples are provided of practical steps that
have resulted in improvements. The reaction of most people when there is mention of
doing todays work today is this is impossible, it will open the floodgates. This is based
on the premise that attempting to prioritise demand from patients is the best means of
coping with high levels of demand in general practice. In reality, many of the systems that
we are used to operating simply deflect demand to another day, perhaps several days
away, in order to protect today. This then blocks the future ability to deal with demand
and has a recurrent knock-on effect on access. It does not reduce demand and
paradoxically, is likely to increase it.
Why? Because patients