Driving improvement: Case studies from GP practices

This publication from the Care Quality Commission looks at 10 GP practices that have achieved a significant improvement on their rating.

Key themes

Image source: http://www.cqc.org.uk

The practices in this report faced similar challenges. They all showed an impressive commitment to improve their service to patients. To achieve this they shared common experiences:

  • strong leadership from a practice manager with the time and skills to lead the practice team
  • addressing staffing and training issues such as poor recruitment or training practices
  • making sure every member of the practice team understood their own and others roles and responsibilities
  • involving the whole team in running the practice
  • involving patients and the local community
  • using external support to help improvement

Their experiences show that improvement in GP practices is possible. The case studies highlight some clear actions that other practices can use to help them learn and improve.

Full report: Driving improvement: Case studies from 10 GP practices


Data sharing in general practice

Sharing to improve: four case studies of data sharing in general practice | The Health Foundation


A new briefing from the Health Foundation, Sharing to improve: four case studies of data sharing in general practice, introduces approaches to collaborative data sharing that enable improvement in the quality of care. The four case studies in this briefing offer promising early indications that collaborative data sharing – in different configurations of general practice – has potential to make a meaningful contribution to improving the quality of care. Insights from these case studies show different methods of using data to improve care, and share practical learning from groups already experimenting with these efforts.

Full briefing: Sharing to improve: four case studies of data sharing in general practice 

Spotlight on the 10 High Impact Actions

New report outlines a series of recommendations for NHS England and for GPs | Royal College of General Practitioners 

Image source: http://www.rcgp.org.uk

This report is the result of research by the Royal College of General Practitioners on the effectiveness of NHS England’s Time for Care Programme, specifically its 10 High Impact Actions: a range of initiatives that were introduced with the aim of increasing capacity in general practice and reducing GP workload which were introduced two years ago.

The Time for Care Programme is part of the commitments outlined in the GP Forward View and this research is part of our ongoing work monitoring and evaluating all aspects of the GPFV.

The research found that whilst there has been some success helping spread pragmatic advice for GPs, and tools to help tackle workload across general practice, NHS England should expand those schemes with the highest potential to reduce administrative work for GPs and other effective measures.

The report outlines a series of recommendations for NHS England and for GPs. The RCGP is calling on NHS England to expand schemes with high potential to reduce administrative work for GPs and are calling on government to ensure every GP surgery has funding to have access to a dedicated social prescriber in a bid to tackle crippling GP workload and effectively signpost patients to the right services.

iSPACE – dementia friendly GP surgeries

iSPACE is helping surgeries improve support for patients with dementia and their carers | AHSN

iSPACE is a quality improvement and innovation programme delivered in GP surgeries in all parts of Hampshire, Dorset, Isle of Wight and south Wiltshire. The aim of iSPACE is to improve the pathway of patients with dementia and their carers through primary care.

The key to the spread of iSPACE is the engagement of staff teams and a recognition that people with dementia need a more personalised care plan and access to resources to help them and their carers to better manage the pathway.

Wessex Academic Health Science Network (AHSN) worked with Alzheimers charities, clinical commissioning groups (CCGs), Public Health England (PHE), Health Education England (HEE) and companies providing dementia services both within and outside the NHS to deliver this project. The AHSN delivered the project into 153 GP surgeries providing training, access to resources, meetings to encourage progress and physical resources such as funding for environmental changes and literature.

Patients reported feeling more supported by their surgery; carers reported a greater understanding of dementia from the surgery team and seeing the same clinician at each appointment. Dementia diagnosis rates increased (15.9% for people aged over 65), care planning increased by 26% for face to face reviews and 80% of surgeries now have a dementia noticeboard.

Full detail at The AHSN Network

Patients get the green light for smarter choices after latest GP pilot

New trial results from the Behavioural Insights Team show improved service access | NHS England

traffic.pngA pilot system is now making it easier for GPs to understand the waiting times at hospitals for their patients. The e-traffic light system could help reduce hospital waiting times while offering patients a clearer choice of treatment and is set to be rolled out across the country after a successful NHS trial.

A tweak to the GP referral system sees a red light appear against a hospital with longer waiting times while a green light shows those with spare capacity, meaning doctors can offer patients potentially quicker routes to treatment and help them make more informed choices.

Results from two London trials have been promising – red lights reduced referrals to overbooked hospitals by nearly 40 per cent, while green lights increased referrals to hospitals with available capacity by 14 per cent this winter.

The Capacity Alert system was developed after NHS England commissioned the Behavioural Insights Team (BIT) to come up with ways of helping hospital trusts ease pressure on services.

Following the success of the trials in North East and South West London, BIT is now supporting the roll-out of the Capacity Alert system across the NHS in England.

Full story at NHS England

See also: Traffic light system could reduce hospital waiting times | National Health Executive


Workload in general practice

Ensuring patient safety through control of workload and demand management in general practice | The British Medical Association (BMA)


General practice in England has seen consultation rates soar by nearly 14 per cent between 2007 and 2014, while the 12 months between 2016-17 saw the total number of full-time equivalent GPs fall by 3.4 per cent.

The BMA suggest that this increase in workload is because of growing patient need (complex multi-morbidity) as well as a result of the widespread recruitment and retention crisis and a lack of long-term investment in general practice. It is argued that the issue of GP workload must be addressed urgently.

This document seeks to address the current challenges in primary care.  It sets out a strategy aimed at improving safety and quality of patient care by recommending the development of agreed workload limits at a local level supported by national guidance.

Full document: Workload Control in General Practice. Ensuring Patient Safety Through Demand Management

Getting the best out of general practice

Rosen, R. | (2018) | Divided we fall: getting the best out of general practice| Research report| Nuffield Trust

The traditional model of general practice, sometimes called ‘medical generalism’, involves GPs developing a relationship with a patient, and understanding their social and family background. It can make them more able to decide when medical treatment is not helpful or necessary, and to manage patients safely outside hospital. This report asks what might be lost as doctors and patients are reallocated to services focused on easy access, such as walk -in centres. Are general practitioners at risk of losing the value this delivers to patients and the wider NHS? (Nuffield Trust)

The report considers what GPs and national NHS bodies can do to get the best of both worlds.
It is available from the Nuffield Trust