Evidence-based management?

The series of articles in the British Journal of General Practice have provoked some thought, for me, concerning the imminent introduction of Advanced Access to our practice.1-4 We were among the practices recruited to the National Primary Care Collaborative (NPCC) first wave. During the last 3 years we have been developing other aspects of our practice. In particular, the infrastructure, which includes both the building in which we work, and the use of the IT resources to become ‘paper-light’. We have also become a personal medical services practice, in which, theoretically, patients are no longer allocated to an individual GP. Patients are, however, traditionalists, and cling to the idea of being registered with an individual practitioner. As has been noted for emergency care, ‘inverting pyramids takes time’.5 The writer of this letter to the BMJ , a consultant in accident and emergency, made the erroneous observation that ‘in primary care most …