Gilbert Hitchcock House
21 Kimbolton Road
Bedford
MK40 2AW
Clinical Governance Office Direct Dial: 01234 795760
Fax: 01234 342028
CLINICAL GOVERNANCE
PRACTICE QUALITY IMPROVEMENT PROGRAMME (PQIP) 2006-07
FOR GP PRACTICES
INTRODUCTION
The options for the PQIP were discussed at the Clinical Governance Leads Meeting following on from a ‘brainstorming’ session earlier in the year. The consensus view was to opt for a structured scheme but with some flexibility. This is described further in more detail.
The contents build on previously identified requirements as well as anticipating future requirements.
QUALITY TEAM DEVELOPMENT
In January 2006 the Department of Health issued a White Paper entitled Our Health, Our Care, Our Say. A summary of the RCGP’s summary document is attached. Within this document the government considers the need to assess the quality of primary care practices through the Healthcare Commission. Currently the RCGP’s Quality Team Development scheme (QTD) is the only scheme to meet these requirements and provides the only guidance for future expectations. Further information on this can be found at www.rcgp.org.uk under Standard and Clinical Interests, Quality Initiatives.
The extremely broad QTD programme is a framework with a comprehensive evaluation of clinical governance processes in a practice. It is designed to support general practices in improving the quality of their services, regardless of their existing level of quality.
QTD can:
· engage all members of the practice team in clinical governance
· identify those things the practice does well and prioritise areas for improvement
· support practice teams in finding solutions and improving the quality of their service
· provide a firm basis for practice development planning
· support achievement of the Quality and Outcome Framework
· improve team morale
· act as a catalyst for change
· provide a framework for reviewing practice roles and structures
The format of the PQIP was discussed and agreed by those present at the Clinical Governance Leads meeting on 8th March 2006. Practices chose to include within the PQIP structured requirements that could support future systems of accreditation. At their request it was agreed that the PCT would review the non-QOF components of the QTD to provide a picking list from which Practices can select one topic, thus providing some freedom but also some common themes. As the QTD is a complicated scheme the PCT has selected and tailored topics to give more manageable options.
BEING OPEN
National Patient Safety Agency, Safer Practice Notice 10, 2005. Being Open When Patients are Harmed:
Action for the NHS
To improve the quality and consistency of communication when patients are involved in an incident, all NHS organisations (including Foundation Trusts) providing patient care in England and Wales should:
1. Develop a local policy, based on the NPSA’s Being Open policy but adapted to suit local requirements, by June 2006. Local policies should be integrated with existing risk management and clinical governance structures. Organisations with policies already in place are encouraged to review their policy in line with Being Open.
2. Raise awareness of the local policy amongst healthcare staff and provide them with the appropriate information and support. The NPSA has developed tools to help.
Promoting a culture of openness is a prerequisite to improving patient safety and the quality of healthcare systems. It involves apologising and explaining what happened to patients who have been harmed as a result of their healthcare treatment. It ensures communication is open, honest and occurs as soon as possible following an incident. It encompasses communication between healthcare organisations, healthcare teams and patients and/or their carers.
Effective communication with patients begins at the start of their care and should continue throughout their time with the healthcare organisation. This should be no different when a patient safety incident occurs. Openness about what happened and discussing patient safety incidents promptly, fully and compassionately can help patients cope better with the after-effects. Patient safety incidents also incur extra costs through litigation and further treatment; Openness and honesty can help prevent such events becoming formal complaints and litigation claims. Openness when things go wrong is fundamental to the partnership between patients and those who provide their care.
Other research has shown that patients are more likely to forgive medical errors when they are discussed fully in a timely and thoughtful manner, and that being open can decrease the trauma felt by patients following a patient safety incident.
The PCT has tailored the policy and will make it available for use in Practices. The full document is available at www.npsa.nhs.uk.
WHISTLEBLOWING
NHS Employers have distributed packs on Whistleblowing to all Practices and this was previously raised at a Clinical Governance Leads meeting.
Whistleblowing means sharing significant concerns about a colleague’s performance with the PCT who will then investigate the concern and take appropriate action. Dr Catherine Carmichael, Director of Public Health, is the responsible director at the PCT and concerns that cannot be dealt with by the Practice’s own internal systems should be notified to her. Cate is based at Gilbert Hitchcock House, tel 01234 795714.
All practices should adopt a policy and the PCT will provide a template to facilitate this.
Further information is available at www.nhsemployers.org
Protected Learning Zone Meetings
PLZ meetings are not a requirement of the PQIP, however the Clinical Governance budget will continue to provide emergency on call cover for PLZ because Practices asked for this. This protected cover provides an opportunity to hold Practice meetings.
Cover will be provided on the following dates, 12.30-4.30pm:
11 April 2006
10 May 2006
15 June 2006
12 July 2006
7 September 2006
10 October 2006
7 December 2006
14 February 2007
13 March 2007
To qualify for cover Practices are requested to provide a copy of their PLZ meeting minutes to the GP Tutor via the Clinical Governance team.
PQIP 2006-07
The programme will run from 1st April 2006 to 31st March 2007.
A payment of £750.00 will be made to practices on submission of a progress report on their action plan at the end of the year. N.B. Reports must be submitted by 28th February 2007 to ensure payments are made.
The PQIP is in four sections:
- Leads meetings, 4 per year, PCT led.
- Training-needs analysis and plan, GP Tutor supported.
- Being Open and Whistleblowing Policies, PCT to provide templates.
- One option from the list of 5 given, PCT support given.
To sign up for the PQIP please complete the sign up form with your practice details and complete and return a copy of the action plan to show your choice of options.
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PQIP PROGRAMME 2006-07
Please complete and return a copy to Shirley Moon, Clinical Governance, Bedford PCT.
PQIP Item / Practice Action / Who will Lead? / What needs to be done? / By When? / PCT Action / £CG Leads Meetings / The Practice Clinical Governance Lead or practice deputy to attend 4 PCT Clinical Governance Leads meetings per year.
N.B. QOF will be a standing agenda item with time for discussion and all other sections of the PQIP. There will be no formal presentations without prior agreement. Format will be supportive discussion around the PQIP topics and QOF.
Dates: 24.5.06, 13.9.06, 13.12.06, 21.3.07.
Venue: Riverfield Drive. / Clinical Governance Facilitator to organise Leads meetings. / £300.00
(£50 per meeting)
Training Needs Analysis and Plan / Agree Practice wide training assessment action plan. To include meeting with GP Tutor. / GP Tutor to meet with Practice. / £100.00
Being Open & Whistle-blowing / Practice to adopt a Being Open policy and a Whistleblowing policy following the guidelines provided by the National Patient Safety Agency and NHS Employers. / PCT will provide templates and training at a Clinical Governance Leads meeting. / £50.00
PQIP Action Plan / Practice to select a practice specific quality improvement action plan. Report on activity completed to be submitted to CG team by 28 February 2007
Support and learning to be shared at CG Leads meetings.
Practice to choose ONE item from the following 5 options: / £300.00
OPTION 1
Practice to develop own Clinical Governance programme including detailed action plan and two minuted meetings. Action plan and minutes to be provided to PCT. / Clinical Governance Facilitator available to meet with Practice to support choice of action plan.
OPTION 2
The team uses management plans for the care of patients with a chronic disease not listed in the national Quality and Outcome Framework (e.g. multiple sclerosis, rheumatoid arthritis).
Management plans should include Doctors, Practice Nurses, District Nurses and Health Visitors and how the team is trained to deliver it.
Any management plans or protocols are evidence-based, compatible with national and local guidelines and requirements and are reviewed at regular intervals.
Ref: QTD 3 B&C – Management of Chronic Illness: ‘The team manages patients with chronic diseases in line with modern opinion and guidelines’. / PCT to assist with NICE guidance which may assist with plans.
GP Tutor available to advise on management plans.
OPTION 3
Patients with chronic diseases are fully involved in their care. Personal responsibility and self-care are promoted.
Patients and carers are offered support and information about appropriate self-help and support groups.
Ref: QTD 3 H&I – Management of Chronic Illness. / Description of how this is achieved for one disease area.
OPTION 4
The practice operates an audit programme for the care of patients with a chronic disease using the criteria in their Practice protocols and/or national guidance.
Ref: QTD 3 K – Management of Chronic Illness
OPTION 5
The team operates an agreed policy for prevention, investigation, management and referral for sexually transmitted infections.
The team operates a policy for the screening for infection with Chlamydia.
Ref: QTD 9 J&L – Women’s Health & Family Planning: ‘Women patients have access to a comprehensive service which meets accepted professional standards and their needs.’ / PCT to provide policy templates and support from Health Promotion Specialist for Sexual Health.
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CLINICAL GOVERNANCE
PRACTICE QUALITY IMPROVEMENT PROGRAMME (PQIP) 2006-07
FOR GP PRACTICES
SIGN UP SHEET
Practice Name:
Practice Address:
We wish to take part in the Practice Quality Improvement Programme for 2006-07.
Signature:
Name:
Position:
Date:
Practice Requests / Yes/No / Please list preferred dates/timesDo you require John Kedward, GP Tutor, to contact you to arrange a practice visit to discuss Primary Care education? / 1.
2.
3.
Do you require Sarah Evans, Health Promotion Specialist – Sexual Health, to contact you to arrange a practice visit to discuss Option 5? / 1.
2.
3.
Do you require Shirley Moon, Clinical Governance Facilitator, to contact you to arrange a practice visit to discuss your programme? / 1.
2.
3.
Please return this form by 31st May 2006 to:
Shirley Moon, Clinical Governance Facilitator
Gilbert Hitchcock House
21 Kimbolton Road
Bedford
MK40 2AW
Or Fax to 01234 342028
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