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The meaning of the 24/48 hour target - definitions, monitoring and resources

  • Last modified date:
    20 August 2007

Enabling patients to be seen at a time more convenient to them

The target simply means that all patients should be seen by a GP within two working days or a primary care professional within one working day if they wish to do so. Equally, patients may wish to be seen at a time more convenient to them outside the target's timescales, or to wait longer to see their preferred GP or health professional, and appointment systems should allow them to do so.

Definitions

The following definitions provide a more detailed explanation of what the target aims to achieve and they include a revised definition of a primary care professional (PCP).

  • 'A GP' - any general practitioner. This is not a named GP, nor is it necessarily a GP at the registered practice, but is expected to be one who is convenient and easily accessible to patients.
  • 'Within 48 hours' - within two normal working days (ie not including Saturday or Sunday or Bank Holidays) following the day when a request by a patient was made. This does not include emergency appointments.
  • 'A primary care professional' - any health care professional including GPs, practice nurses, allied health professionals, other health care staff who is a member of the practice or wider local primary care team, a community pharmacist for instance. This is not a named PCP nor is it necessarily a PCP at the registered practice, but is expected to be one who is convenient and easily accessible to patients.
  • 'Within 24 hours' - by the end of the next normal working day (ie not including Saturday or Sunday or Bank Holidays). This does not include emergency appointments.
  • 'Patients' - patients registered with a general practitioner. It will be for the PCT to make sure there is appropriate access across their locality.
  • 'To see' - face to face personal contact. Telephone consultations can reduce the overall demand for appointments but they can not be counted for the purposes of this target.
  • 'By 2004' - by 31 December 2004.

In practices where patients cannot see a GP routinely within two working days and a PCP within one working day, PCTs should have in place formal joint working arrangements with other local practices or other health service providers, including NHS Walk-in Centres, to offer a complementary source of provision.

Monitoring arrangements

Progress towards the target is monitored through the monthly PC Access Survey and is based on the next available appointment. PCTs are responsible for providing information for all their practices each month and for the accuracy of the information. The survey is carried out through the Strategic Executive Information System (STEIS) and is supported by guidance notes including what can be counted towards the target.

For more information on STEIS, click on the link below to visit the Strategic Executive Information System (STEIS) website.

Resources

Achievement of the 24/48 hour access target is one of the Government's key priorities. As such it has been backed by recurrent resources amounting to £168m per annum in the form of the PC Access Fund. In line with Shifting the Balance of Power, funding within the PC Access Fund is no longer earmarked, allowing maximum local flexibility for PCTs to use all of the resources available to them including the Primary Care Incentive Scheme.

What PCTs should know:

PCTs should use this funding to:

  • Provide PC Access Implementation Payments to practices to encourage them to take up the NPDT's Advanced Access model in full (around £5,000 for an 'average'-sized practice).
  • Provide PC Access Incentive Payments to practices who can demonstrate sustained achievement of the target, either through practising Advanced Access or other means, and to reward continued improvements.
  • PCTs should agree these payments locally in conjunction with practices, other service providers and the LMC.

In addition, £13m has been made available to the National Primary Care Development Team (NPDT) to promote the spread of the Advanced Access model. PCTs who had not been funded as part of the original four waves of the Primary Care Collaborative, have received £25,000 for the two years April 2003 to March 2005 to fund an Access Facilitator. Their role is to:

  • Provide local support and advice to practices as well as sharing best practice
  • Be the PCT link to the NPDT centres, and to spread examples of best practice and innovation.

Allocation details were notified to PCTs in HSC 2002/012 Primary Care Trust Revenue Resource Limits 2003/04, 2004/05 & 2005/6.

In addition to financial resources, the Changing Workforce Programme (CWP) is part of the Modernisation Programme providing support to make radical and sustainable change for the benefit of patients. The publication Workforce Matters - A good practice guide to role design in primary care includes examples of new or redesigned roles that have improved services and have enriched the working lives of staff in primary care.

CWP has also produced a role design workshop for local change. It is a series of practical workshops that facilitate the development and implementation of new ways of working at a local level. More details are available via the same link.

See other key components in this toolkit: -

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