rcgp presentation 2017
TRANSCRIPT
Promoting Excellence in Family Medicine
RCGP Special Measures Programme
Alison Johnson, SM AdviserJayne Dewhurst, Deputy Lead
RCGP SM Programme What do we offer?
Peer advice and support to GP practices that enter special measures after a CQC inspection Commissioned by NHSE MOU between practice, RCGP, contract holderUp to £10k per practice, funded by NHSE
Volume of PracticesDescription Numbers %Total Number of Enquiries
146
Total Number of Practices Ever Supported
93 64%
Current Number of Active Practices
36
• Numbers at 8th February
• Further 6 Practices due to come on stream
• Large Number of enquiries pending
Methodology
Initial conversations, various sources Pre-scoping clinical lead/deputyScoping – CQC report, stakeholders, practice visitScoping –Root Cause analysis --Improvement plan—practice with supportTurnaround plan costed—RCGP teamOngoing support to practice
Examples of Support
Stabilise, increase capacity, embedUnderstanding key documentsPrioritisingImprovement planningLiaison with NHSE and key stakeholdersHelping with basic policiesSupporting appointment of key staff
More examples
Looking at practice viabilityActing as a stabilising influenceRaising clinical governance issuesLiaising with other sources of support AssuranceFacilitating meetings e.g. strategy, audit, CQC preparation
Interim Evaluation key themes
Root causesScoping VisitInsight and EngagementRemediable practicesRelationships with stakeholders
Root Causes
Lack of effective Clinical LeadershipLack of effective Practice Management
Both must understand what needs to be done and be able to make it happen
IsolationFrom others externallyWithin the practice
Root causes inter-related
Branch surgeriesBuildings issuesFinancial Contract issues
Negative cycles common
Other root causes
Predictors of Success
Early RCGP interventionHelp write realistic action planLonger period of supportPossible marker of good engagement
Stakeholder support goodPositive monitoring against clear actionsGood communication
Local resources and peer to peer support
Predictors of success
InsightEngagementGiving/getting the whole picture
OutcomesOutcomes of Reinspection Number %Good 26 48%
Requires Improvement – Out of SM 9 17%
Inadequate – Emergency Closure 2 4%
Inadequate – Stay in SM 4 7%
Inadequate Closed with Notice 1 2%
Requires Improvement – Stay in SM 5 9%
Closed prior to Reinspection 0 0%
Early Withdrawal 3 5%
GP Retired/Resigned 2 4%
Practice Merger/Acquisition 0 0%
Other 2 4%
The Future
RCGP plans to offer commissioners smaller suite of services for upstream support
e.g.Scoping visit, root cause analysis and improvement planFollow up pre-CQC visit Facilitation of away days (Well Led)