july 2016 gp commissioning and contracting quality and ...€¦ · ipsos mori administers the...

DRAFT North Central London CCGs

July 2016 GP Commissioning and ContractingQuality and Performance Report


July 2016 NCL Primary Care Joint Committee

Quality and Performance Report

Prepared By: NHS England

Date: 06/07/2016

Section Title Page Data Source

1.0 Patient Satisfaction 3

1.1 GP Patient Survey 4 GP Patient Survey

1.2 Friends and Family 9 http://www.england.nhs.uk/wp-content/uploads/2015/10/fft-gp-0915.xlsm

2.0 Primary Care Quality Data 11

2.1 QOF Performance Data 12 HSCIC QOF report

2.2 CQC Assessment Data 14 CQC

3.0 Performer Data Summary 15

3.1 Summary of Performer Performance Concerns 16 Medical Directorate

4.0 Contractual Data Summary 17

4.1 Summary of Primary Care Service Provision 18 Contract team

4.2 Summary of Contractual Issues and Concerns 20 Contract Team

Index

2


PATIENT SATISFACTION

3


GP PATIENT SURVEY

Overall Experience of GP Surgery

National Barnet Camden Enfield Haringey Islington

Ease of Getting Through on the Telephone


North Central London reported lower than national average on satisfaction , for ease of getting through on the telephone. Satisfaction levels are falling across

most CCGs. Satisfaction is at the lowest levels in Barnet and Haringey. Satisfaction levels fell by 5% in Enfield since the previous survey in July 2015.

Overall positive experiences of GP surgeries are slightly lower in North Central London, than the national average. Overall, the satisfaction has increased since

the last GP Patient Survey.

85%

5%

81%

6%

81%

5%

81%

6%

77%

10%

81%

6%

71%

26%

61%

34%

71%

23%

64%

32%

67%

29%

72%

23%

4


Helpfulness of Receptionist


Overall Experience of Making an Appointment


Satisfaction with the overall experience of making an appointment is lower than the national average across North Central London. This is particularly marked in

Haringey, which is some 7% below the national average. Satisfaction levels fell in Enfield by 4% since the previous survey.

North Central London reported satisfaction levels marginally lower than national averages on this measure. Satisfaction levels with the helpfulness of

receptionists are increasing across most CCGs.

87%

11%

84%

13%

86%

12%

85%

14%

83%

15%

86%

12%

73%

12%

68%

14%

70%

13%

68%

15%

66%

16%

69%

15%

5


Confidence and Trust in GP


Confidence and Trust in Nurse


Satisfaction with confidence and trust in nurses is lower than national average for North Central London. Satisfaction levels are generally falling across North

Central London, since the last survey, with the most significant dips in Islington CCG (4%) and Camden CCG (3%).

Confidence and trust in GPs is at, or is near national levels of satisfaction across North Central London, with the exception of Haringey where satisfaction levels

are 5% below the national average.

92%

5%

91%

5%

90%

4%

89%

6%

87%

8%

90%

5%

84%

3%

78%

4%

69%

4%

77%

4%

75%

6%

74%

5%

6


Satisfaction with Opening Hours


Satisfaction with opening hours is below the national average in North Central London. Satisfaction in Islington is 7% below, and in Barnet is 6% below the

national average. Satisfaction levels are generally falling, since the last survey.

75%

10%

69%

14%

71%

12%

74%

10%

70%

14%

68%

15%

7


Key

Satisfaction with opening hours is below the national average in North Central London. Satisfaction in Islington is 7% below, and in Barnet is 6% below the

national average. Satisfaction levels are generally falling, since the last survey.

Notes

The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level data about patients’ experiences of their GP practices.

Ipsos MORI administers the survey on behalf of NHS England.

For more information about the survey please visit https://gp-patient.co.uk/.

The data in this report are based on the January 2016 GPPS publication. This combines two waves of fieldwork, from January to March 2015 and July to

September 2015, providing practice-level data.

Increasing levels of satisfaction

Stable levels of satisfaction

Decreasing levels of satisfaction

dissatisfied

satisfied

8


The GP Patient Survey measures patients’ experiences across a range of topics, including:

- Making appointments

- Waiting times

- Perceptions of care at appointments

- Practice opening hours

- Out-of-hours services

The GP Patient Survey provides data at practice level using a consistent methodology, which means it is comparable across organisations and over time.

The survey has limitations:

- Sample sizes at practice level are relatively small.

- The survey does not include qualitative data which limits the detail provided by the results.

- The data are provided twice a year rather than in real time.

All comparisons are indicative only. Differences may not be statistically significant – particularly when comparing practices due to low numbers of responses.

However, given the consistency of the survey across organisations and over time, GPPS can be used as one element of evidence.

It can be triangulated with other sources of feedback, such as feedback from Patient Participation Groups, local surveys and the Friends and Family Test, to

develop a fuller picture of patient journeys.

9


FRIENDS AND FAMILY

CCG

Practices

Expected to

Submit

Practices

Submitting Responses

%

Recom

% Not

recom

Direction of

Travel

Barnet 62 41 1,105 83% 9%

Camden 35 28 325 89% 7%

Enfield 49 38 1,152 85% 10%

Haringey 44 29 859 91% 4%

Islington 34 26 413 87% 5%

NCL 224 162 3,854 86% 8%

London 1,354 938 32,797 86% 8%

National 7,594 5,381 159,985 88% 7%

Commentary

This is the latest available monthly data, as at April 2016.

There was no return from 62 practices during this period, an increase on previous periods. Overall response levels are generally low, and fell for all CCGS

since the last report. CCGs may wish to work with PPG leads to try and secure a greater level of participation.

Overall recommendation levels are close to London and national levels, with the exception of Barnet and Enfield which reported slightly lower levels of

recommendation.

0%

20%

40%

60%

80%

100%

120%

% Not recom

%Recom

Percentage of practices recommended / not recommended in Friends and Family feedback

10


What is GP FFT?

FFT gives patients the opportunity to submit feedback to providers of NHS funded care or treatment, using a simple question which asks how likely, on a

scale ranging from extremely unlikely to extremely likely, they are to recommend the service to their friends and family if they needed similar care or

treatment. GP practices have been required to make the opportunity to provide feedback through the FFT available to their patients since 1 December

2014, and submit data to NHS England each month since the end of January 2015. Further information can be found on the FFT webpage:

http://www.england.nhs.uk/ourwork/pe/fft/

Usage of the data

The FFT does not provide results that can be used to directly compare providers because of the flexibility of the data collection methods and the variation in

local populations. This means it is not possible to compare like with like. There are other robust mechanisms for that, such as national patient surveys and

outcome measures. The FFT can help mark progress over time for organisations and still provides patients with useful data to inform choice, alongside other

information. The real strength of the FFT lies in the follow up questions that are attached to the initial question, and a rich source of patient views can be

used locally to highlight and address concerns much faster than more traditional survey methods. The comments are not submitted to NHS England but may

be available from your practice locally to view alongside the monthly data.

11


PRIMARY CARE QUALITY

12


QOF Performance

1 2 3 4

CCG

2013/14 2014/15 % Change 2013/14 2014/15 % Change 2013/14 2014/15 % Change 2013/14 2014/15 % Change 2013/14 2014/15 % Change

Barnet 386,437 396,936 2.7% 91.6% 94.2% 2.6% 93.6% 95.6% 2.0% 94.4% 95.9% 1.5% 94.1% 94.6% 0.5%

Camden 243,946 264,281 8.3% 93.1% 93.4% 0.3% 94.6% 93.7% -0.9% 92.7% 89.3% -3.4% 92.9% 93.5% 0.6%

Enfield 303,653 320,186 5.4% 87.2% 91.7% 4.5% 92.7% 93.9% 1.2% 94.9% 96.8% 1.9% 88.7% 92.4% 4.1%

Haringey 269,956 288,081 6.7% 90.3% 90.0% -0.3% 94.8% 93.9% -0.8% 95.7% 93.8% -1.9% 92.6% 90.9% -1.9%

Islington 228,516 233,797 2.3% 93.5% 93.4% 0.0% 95.4% 94.7% -0.7% 95.4% 94.8% -0.6% 94.0% 93.7% -0.3%

London 8,970,868 9,245,690 3.1% 91.5% 92.8% 1.3% 93.8% 94.9% 1.1% 95.0% 95.5% 0.5% 92.9% 93.4% 0.5%

National 55,768,700 56,817,654 1.9% 92.5% 94.5% 1.9% 93.7% 95.3% 1.5% 97.3% 97.3% 0.0% 93.9% 94.8% 0.9%

Commentary

Quality Outcomes Framework

Population growth outstrips national and London averages in Camden, Haringey and Enfield, and outstrips the national average across the board.

QOF measures are improving markedly in Enfield and marginally in Barnet and Camden.

Slight declines are noted in Haringey and Islington.

Last updated 29 October 2015

List Size 1. Clinical 2. Public Health 3. Public Health - Additional Services 4. All Domains

Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievement results.

The QOF is the annual reward and incentive programme detailing GP practice achievement results. It rewards practices for the provision of quality care and helps standardise improvement in the delivery of primary medical services.

It is a voluntary process for all surgeries in England and was introduced as part of the GP contract in 2004. The indicators for the QOF change annually, with new measures added and other indicators retired. For 2014/15, the QOF awards practices

achievement points for:

- managing some of the most common chronic diseases, e.g. asthma, diabetes

- managing major public health concerns, e.g. smoking, obesity

- implementing preventative measures, e.g. regular blood pressure checks

The QOF contains three main components, known as domains. The three domains are: Clinical; Public Health and Public Health – Additional Services. Each domain consists of a set of achievement measures, known as indicators, against which

practices score points according to their level of achievement. The 2014/15 QOF measured achievement against 81 indicators; practices scored points on the basis of achievement against each indicator, up to a maximum of 559 points.

clinical: the domain consists of 69 indicators across 19 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 435 points.

public health: the domain consists of seven indicators (worth up to 97 points) across four clinical areas – blood pressure, cardiovascular disease – primary prevention, obesity 16+ and smoking 15+.

public health – additional services: the domain consists of five indicators (worth up to 27 points) across two service areas – cervical screening and contraception.

The QOF gives an indication of the overall achievement of a surgery through a points system. Practices aim to deliver high quality care across a range of areas for which they score points. Put simply, the higher the score, the higher the financial

reward for the practice. The final payment is adjusted to take account of surgery workload, local demographics and the prevalence of chronic conditions in the practice's local area.

13


CQC GP PRACTICE INSPECTIONS

CCG

Number of

practices

Barnet 62 0 0.0% 21 33.9% 4 6.5% 1 1.6% 36 58.1%

Camden 31 0 0.0% 10 32.3% 1 3.2% 2 6.5% 18 58.1%

Enfield 48 0 0.0% 7 14.6% 3 6.3% 0 0.0% 38 79.2%

Haringey 46 0 0.0% 13 28.3% 2 4.3% 1 2.2% 30 65.2%

Islington 34 0 0.0% 13 38.2% 0 0.0% 0 0.0% 21 61.8%

NCL 221 0 0.0% 64 29.0% 10 4.5% 4 1.8% 143 64.7%

London 1375 9 0.7% 430 31.3% 99 7.2% 20 1.5% 817 59.4%

National 7595 165 2.2% 3368 44.3% 411 5.4% 122 1.6% 3529 46.5%

Commentary

Last updated 27th June 2016

http://www.cqc.org.uk/search/services/doctors-gps?location=&sort=default&la=&distance=15&mode=html

It is currently challenging to compare performance to London or National benchmarks, given the low proportion of practices currently inspected.

Of particular note is that 64.7% of practices are still awaiting inspection or their report. This limits the conclusions that can be drawn on overall performance within NCL.

The CQC's programme of inspection is now providing greater coverage, however, which will increase the meaningfulness of this information.

No Published

RatingOutstanding Good

Requires

Improvement Inadequate

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Barnet Camden Enfield Haringey Islington

Outstanding

Good

RequiresImprovement

Inadequate

No PublishedRating

Percentage of practices in each CQC assessment category

14

http://www.cqc.org.uk/search/services/doctors-gps?location=&sort=default&la=&distance=15&mode=html


INDIVIDUAL PERFORMER DATA SUMMARY


Individual Performer Performance Issues

CCG

High Med Low

Barnet 10 0 7 3

Camden 9 1 2 6

Enfield 19 4 7 8

Haringey 11 0 5 6

Islington 4 0 1 3

NCL 53 5 22 26

Commentary

Performer Rating

Dark Blue - potential contractual termination

Mid Blue - potential breach

Light Blue - monitor

Number of

Performer

live cases

53 live cases out of 617 (as of May 16) practitioners in North Central London (8.6%).

Thematic key issues:

- Clinical issues:

- Inappropriate behaviour:

- Financial probity:

- Criminal allegations:

- Manner and attitude:

- Health issues:

16


CONTRACTUAL DATA SUMMARY

17


Primary Care Service Summary

CCG

Total

Partnership

Changes GP Retirements

Change in Practice

Details

Contractual

Change Mergers Terminations PMS to GMS List Closure % Single Handers

Barnet 62 - - - 1 - - - - 22.5%

Camden 35 5 - 1 - - - - - 20.0%

Enfield 48 - 1 - - - - - - 27.1%

Haringey 43 4 1 - - - - - - 30.2%

Islington 34 3 - 1 1 - - - - 23.5%

NCL 222 12 2 2 2 - - - - 19.4%

National proportion of single handed practices 18.0%

Comments

Data correct as at 12/7/16

% of single handed contractors is more than the NCL average and Enfield and Haringey have significantly higher.

All NCL boroughs have a higher % of single handed contractors than the national average.

As at 11/7/16

CCG Partnership Change:

One partner resigned from Evergreen House Surgery , Haringey

One partner resigned from Amwell Group Practice, Islington

One partner resigned from Tufnell Park Road Surgery, Islington

One partner resigned from Rutland House Surgery, Haringey

One partner resigned from Brookfield Park Surgery, Camden

One partner resigned from Four Trees Surgery, Camden

One partner resigned from Queens Crescent, Camden

One partner resigned from James Wigg Group Practice, Camden

One new partner joined Evergreen House Surgery , Haringey

One new partner joined Rutland House Surgery, Haringey

One partner joined single-handed practice The Village Practice, Islington

One new partner joined Brookfield Park Surgery, Camden

Practice Closure:

Single hander retired/ practice closure, Bowes Medical Centre, Enfield

Single hander retired/ practice closure, St Johns Road Surgery, Haringey

CCG GP Retirement:

One partner took/returned 24 hr retirement from Rutland House Surgery, Haringey

One partner retirement from Highlands Practice, Enfield

Practice details Changes:

One practice name change , The Surgery E83041,Barnet

One Practice Area change River Place Group Practice, Islington

Practice Relocation:

One relocation Brookfield Park Surgery, Camden

18


Summary of Contractual Breaches

CCG YTD Last Quarter

Barnet

Camden 1

Enfield 1

Haringey

Islington

NCL 2 0

2 breach out of 221 practices in NCL and 1,421 practices in London

Commentary

Number of breaches

Thematic key issues:

- CQC

19

july 2016 gp commissioning and contracting quality and ...€¦ · ipsos mori administers the...

Documents