A short walk! A feasible fitness test for general practice.

Patient Enablement Instrument (PEI), a measure of the patients self-reported ability to cope with illness following a consultation. The results suggest older patients are not disadvantaged by telephone consultations. In fact allowing for greater disability and chronic illness among older patients there was no difference in PEI scores between groups older and younger than 70 years. However, a local evaluation at practices operating a variety of Advanced Access ideas suggests that such practices are experiencing a greater influx of ‘walk-in’ cases (17%) perhaps because getting through on the telephone is more difficult! Patients may be responding by presenting themselves in person making nonsense of efforts to contain workload. Finally, health-care assistant facilitated, open access, 3-minute GP consultations have been trialed in a deprived inner city community in our region. An evaluation suggests that this innovation successfully resolved access problems and was seldom abused. Our impression is that Advanced Access is a complex intervention and in some practices, and for most patients, is viewed as an improvement.