ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2007
Impact of Advanced Access on access, workload, and continuity: controlled before-and-after and simulated-patient study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Association of Advanced Access With Primary Care Performance: A Systematic Review.Annals of family medicine · 2026Pooled it
- Access or continuity: a zero sum game? A systematic review of the literature examining the relationship between access and continuity in primary healthcare.BMC primary care · 2025Pooled it
- Eight Priorities for Improving Primary Care Access Management in Healthcare Organizations: Results of a Modified Delphi Stakeholder Panel.Journal of general internal medicine · 2020Pooled it
- A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care.BMC health services research · 2012Pooled it
- Advanced access scheduling outcomes: a systematic review.Archives of internal medicine · 2011Pooled it
- The effect of nurses' preparedness and nurse practitioner status on triage call management in primary care: A secondary analysis of cross-sectional data from the ESTEEM trial.International journal of nursing studies · 2016Trial
- Trial
- Bugbears in the Waiting Room: Revisiting Arber and Sawyer's Classic Study of GP Reception Work Using Ethnography in Eight English General Practices.Sociology of health & illness · 2025Article
- Access systems in general practice: a systematic scoping review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Article
- Ten years later: A portrait of the implementation of the advanced access model in Quebec.Healthcare management forum · 2023Article
- The association between the workload of general practitioners and patient experiences with care: results of a cross-sectional study in 33 countries.Human resources for health · 2020Article
- Evaluation of the implementation and associated effects of advanced access in university family medicine groups: a study protocol.BMC family practice · 2020Article
- Capsule Commentary on Stryczek et. al., De-implementing Inhaled Corticosteroids to Improve Care and Safety in COPD Treatment: Primary Care Providers' Perspectives.Journal of general internal medicine · 2020Article
- Scheduling models and primary health care quality: a multilevel and cross-sectional study.Revista de saude publica · 2019Article
- Seeing double: expanding GP capacity through teamwork and redesign.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- What Are the Factors Influencing Implementation of Advanced Access in Family Medicine Units? A Cross-Case Comparison of Four Early Adopters in Quebec.International journal of family medicine · 2017Article
- Research into practice: accessing primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Review
- What are the core predictors of 'hassles' among patients with multimorbidity in primary care? A cross sectional study.BMC health services research · 2015Article
- Primary care access and emergency room use among older veterans.Journal of general internal medicine · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCase studies from the US suggest that Advanced Access appointment systems lead to shorter delays for appointments, reduced workload, and increased continuity of care.
aimTo 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.
settingTwenty-four practices that had implemented Advanced Access and 24 that had not.
methodAnonymous 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.
resultsThe 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).
conclusionAdvanced 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.
Indexed as
Identifiers
17688754PMC2099665What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.