A Primary Care Foundation (PCF) report on out-of-hours last month compared GP out-of-hours services at 61 anonymous UK primary care organisations (PCOs) (GP, 10 April).

The report found wide variations in performance. Although the demands on services varied by a factor of two, their costs varied by a factor of four. The proportion of patients later hospitalised varied by a factor of 18.

PCF partner Rick Stern told a recent conference that variations depended more on how providers managed their resources than geography.

Liverpool's Urgent Care 24 compared itself with other providers, and found it was 'unproductive', he said.

In response, the company created a similar system internally, comparing the productivity of each of its clinicians.

'Nine months later it had doubled its productivity,' Mr Stern said. 'And the clinicians are much happier as they've spread the workload better.'

jonn.elledge@haymarket.com

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