Forty-eight hour access to primary care: practice factors predicting patients' perceptions

Background: The government has proposed a 48-hour target for GP availability. Although many practices are moving towards delivering that goal, recent national patient surveys have reported a deterioration in patients' reports of doctor availability. What practice factors contribute to patients' perceptions of doctor availability? Method: A cross sectional patient survey (11 000 patients from 54 inner London practices, 7247 (66%) respondents) using the General Practice Assessment Survey. We asked patients how soon they could be seen in their practice following non-urgent consultation requests and related their aggregated responses to the characteristics of their practice. Results: Three factors relating to practice administration and appointments systems operation independently predicted patients' reports of doctor availability. These were the proportion of patients asked to attend the surgery and wait to be seen, the proportion of patients seen using an emergency surgery arrangement, and the extent of practice computerization. Conclusion: Some practices may have difficulty in meeting the target for GP availability. Meeting the target will involve careful review of practice administrative procedures.

The Press in a world of technological change, 1970–2000

Oxford University Press’s response to technological change in printing and publishing processes in this period can be considered in three phases: an initial period when the computerization of typesetting was seen as offering both cost savings and the ability to produce new editions of existing works more quickly; an intermediate phase when the emergence of standards in desktop computing allowed experiments with the sale of software as well as packaged electronic publications; and a third phase when the availability of the world wide web as a means of distribution allowed OUP to return to publishing in its traditional areas of strength albeit in new formats. Each of these phases demonstrates a tension between a desire to develop centralized systems and expertise, and a recognition that dynamic publishing depends on distributed decision-making and innovation. Alongside these developments in production and distribution lay developments in computer support for managerial and collaborative publishing processes, often involving the same personnel and sometimes the same equipment.