The vision for Primary Care in Wandsworth is that ‘Over the next five years, Wandsworth CCG will work with General Practices to ensure services are high quality and accessible to the local population and to ensure patients are pro-actively supported to maintain their health and remain safely at home for as long as possible’.
The single common definition of quality for the NHS encompasses three parts, care that is safe, effective and provides as positive an experience as possible. These three areas can be defined further as:
Patient Safety: commissioning high quality care which is safe, prevents all avoidable harm and risks to the individual’s safety; and having systems in place to protect patients
Patient Experience: commissioning high quality care which looks to give the individual as positive an experience of receiving and recovering from the care as possible, including being treated according to what the individual wants or needs, and with compassion, dignity and respect; listening to the patient’s own perception of their care
Clinical Effectiveness: commissioning high quality care which is delivered according to the best evidence as to what is clinically effective in improving an individual’s health outcomes. Making sure care and treatments achieve their intended outcome
This simple definition was first set out in High Quality Care for All in 2008, following the NHS Next Stage Review led by Lord Darzi. This definition is now enshrined in legislation.
Within Wandsworth CCG the main vehicle for engaging practices in quality improvement is through the Members Quality and Engagement Scheme (MQES) along with other borough wide initiatives. However participation in these schemes is voluntary and smaller practices, who have less resource and capacity to flex their workforce have traditionally found it harder to engage. This means that they may not benefit to the same extent from the education, shared learning and other quality improvement opportunities available.
In line with the transforming primary care agenda and the CCG’s responsibility to improve quality in primary care, WCCG is looking to support practices to address variation through delivery of the quality agenda.
Taking a borough wide approach to delivering some of this work, through Battersea Healthcare CIC working collaboratively with practices, will ensure all practices have access to the expertise and support to achieve improvements in the delivery of high quality primary care. This will support the development of the Multispecialty Community Provider (MCP) model for Wandsworth, which will see GPs working collaboratively to develop a sustainable, holistic and high quality model for primary care.
Aims and Objectives
- Improve overall standards of quality
- Reduce unwarranted variation in primary care quality across Wandsworth
- Address CCG quality areas: Patient Safety, Patient Experience, Clinical Effectiveness
- Ensure equality of delivery of the agenda across the whole of Wandsworth
- Hold individual practices to account for delivery of specific quality areas
- Identify and address quality issues at an early stage
- Develop collaborative working and shared learning between practices
- Support workforce resilience
Demonstrate improvement in specific, identified quality areas at a Wandsworth wide and individual practice level through supporting and enabling practices in delivery of the quality agenda.
- All practices are engaged in quality improvement leading to reduced variation
- Resilience and sustainability of primary care improved
The delivery of this quality agenda will be through Battersea Healthcare CIC working collaboratively with practices across the borough. We will be required to ensure that this happens in an equitable and efficient way, at least partially, through facilitating “coordinative behaviour” amongst practices to work and deliver a single system for the population whilst holding a clear and recognisable formal role in overseeing delivery of the agenda.
- Support delivery of the Quality Improvement section of the Members Quality and Engagement Scheme (MQES). This is the scheme which practice sign up to, to engage with the Quality Contract
- Ensure delivery of this specification across all practices in Wandsworth. Where a practice is not engaging, having signed up to the MQES, we will work with the practice to identify and address barriers to engagement. This may include supporting the practice in completion and delivery of the Quality Improvement tasks
- Organise and deliver in-practice quality improvement tasks and quality development events on topics agreed in advance with the CCG
- Implement, manage and develop the Practice Support Team, and through the Practice Support Team support delivery of the GP Resilience Programme
- Provide assurance to CCG of delivery of specific areas
- Create a culture of quality assurance and shared learning e.g. learning from CQC inspections
- Have a project manager to lead on delivery of this specification
- Attend the Primary Care Quality Review Group on at least a quarterly basis
The 2018-19 Quality Contract comprises 5 Quality Improvement exercises (Formerly known as “tasks”) and 5 Quality Development Events.