Question design in nurse-led and GP-led telephone triage for same-day appointment requests: a comparative investigation.

Objective: To compare doctors' and nurses' communication with patients in primary care telephone triage consultations.

Design: Qualitative comparative study of content and form of questions in 51 telephone triage encounters between practitioners (general practitioners (GPs)=29; nurses=22) and patients requesting a same-day appointment in primary care. Audio-recordings of nurse-led calls were synchronised with video recordings of nurse's use of computer decision support software (CDSS) during triage.

Does distance matter? Geographical variation in GP out-of-hours service use: an observational study.

Background: GP cooperatives are typically based in emergency primary care centres, and patients are frequently required to travel to be seen. Geography is a key determinant of access, but little is known about the extent of geographical variation in the use of out-of-hours services.

Aim: To examine the effects of distance and rurality on rates of out-of-hours service use.

Improving access to primary care: eight case studies of introducing Advanced Access in England.

Objective: To examine the implementation of 'Advanced Access' as a means of improving access to primary care.

Methods: Qualitative case studies of eight English general practices undertaken as part of a mixed method study.

Results: There was considerable variation in the interpretation and implementation of Advanced Access.

Does Advanced Access improve access to primary health care? Questionnaire survey of patients.

Background: General practices in England have been encouraged to introduce Advanced Access, but there is no robust evidence that this is associated with improved access in ways that matter to patients.

Aim: To compare priorities and experiences of patients consulting in practices which do or do not operate Advanced Access.

Design Of Study: Patient questionnaire survey.

Impact of Advanced Access on access, workload, and continuity: controlled before-and-after and simulated-patient study.

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.

Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction.

Objectives: To explore the impact of establishing walk-in centres alongside emergency departments on patient choice, preference and satisfaction.

Methods: A controlled, mixed-method study comparing 8 emergency departments with co-located walk-in centres with the same number of "traditional" emergency departments. This paper focuses on the results of a cross-sectional questionnaire survey of users.

A systematic review of evidence about extended roles for allied health professionals.

Objective: Extending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles.

Methods: A systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists.

Safety, effectiveness and costs of different models of organising care for critically ill patients: literature review.

New ways of working in critical care are emerging in response to increasing demands for care in the context of a limited critical care workforce. This review appraised the comparative safety, effectiveness and costs of new ways of working in critical care. All papers published in peer reviewed journals during 1990-2003 were utilised.

The introduction of integrated out-of-hours arrangements in England: a discrete choice experiment of public preferences for alternative models of care.

Objective: To establish which generic attributes of general practice out-of-hours health services are important to the public.

Methods: A discrete choice experiment postal survey conducted in three English general practitioner (GP) co-operatives. A total of 871 individuals aged 20-70 years registered with a GP.

Effect of introduction of integrated out of hours care in England: observational study.

Objectives: To quantify service integration achieved in the national exemplar programme for single call access to out of hours care through NHS Direct, and its effect on the wider health system.

Design: Observational before and after study of demand, activity, and trends in the use of other health services.

Participants: 34 general practice cooperatives with NHS Direct partners (exemplars): four were case exemplars; 10 control cooperatives.

Preferences of patients for emergency services available during usual GP surgery hours: a discrete choice experiment.

Objective: A study was undertaken to investigate patients' strength of preferences for attributes or characteristics associated with delivery of emergency primary care services available during usual GP surgery hours and to investigate the trade-offs between attributes.

Methods: A discrete choice experiment was used to quantify patients' strength of preferences for several key attributes of usual-hours emergency primary care. The attributes were chosen to reflect the findings of previous research, current policy initiatives and discussions with local key stakeholders.

Impact of the introduction of fee for service payments on types of minor surgical procedures undertaken by general practitioners: observational study.

The 1990 general practitioners (GPs) contract introduced item of service payment for minor surgery, payable for six categories of procedure. Early review showed no substitution of cheaper procedures for more expensive treatments. Detailed payment data from six Health Authorities for the period 1993-2000 show an 11 per cent increase in claims, largely accounted for by the rise in cautery, incorporating cryotherapy.