Mr Chisholm said the successful development of the programme in Tayside had tremendous implications for other areas of Scotland and for other, more diverse areas of care. Asked why it had not happened before, he said, “The reality is that it is only fairly recently people have thought of new ways of working and now we have to make sure it is spread widely. We expect over the new few years this approach will be commonplace across Scotland.”

He agreed that drastically reducing the number of missed appointments would save the health service many millions of pounds, after Dr John Fletcher, of Wallacetown health centre in Dundee disclosed that his practice had previously recorded between 60-70 missed appointments each week. Dr Fletcher said, “We are now down to five and the missed appointments amounted to something like one and a half days of consultancy time. Because we are seeing people faster, they do not have time to dwell on their problems, which ultimately added arms and legs to their condition.”

Dr Rebecca Locke of Monifieth Health Centre, said her practice had previously the worst record with patients waiting for twelve days for an appointment.

“We are now down to the same day. We had to change our culture of thinking and we now are able to match capacity to demand, from telephone consultations to access to nurses for advice.”

Prior to the Tayside project, patients in some practices were waiting up to 15 days to get an appointment to see their doctor. Now, with a minimum of advance appointments and the majority able to phone their surgery and getting same-day appointments, missed appointments have also been much reduced and there is high patient satisfaction.

The 18 rural and urban practices in Tayside examined the times when there was most demand and, in at least one practice, doctors ceased to take a half day on Mondays when there tended to be a heavier demand after the weekend. At another practice, consulting times have been extended and many patients waiting for the results of tests now get a phone call instead of having to make an appointment. In addition, phone consultations have been launched so that anyone with queries or seeking advice over the phone can call daily between noon and 1pm.

The first five months of the scheme illustrated a 19% improvement for patients seeking appointments with the GP of their choice and a 45% improvement for appointments with practice nurses.

Mr Chisholm earlier in the year announced there would be funding of £7.6 million to help roll out the programme — entitled the Scottish Primary Care Collaborative — across 400 practices in Scotland over the next three years. Collaboratives in England have already seen significant benefits to patients through improved access, with a 72% reduction in waiting times to see doctors and 95% of patients being seen on the day of their choice.