How to Drive Improvement at Your GP Practice
Building a successful GP Practice and driving improvement certainly comes with its challenges.
Faced with a growing number of GP vacancies, lack of support and rising list numbers, many practices are becoming over-stretched and under pressure. Adopting a ‘one size fits all’ approach doesn’t always work and sets them up for failure.
It is a disheartening blow for practices that receive a ‘requires improvement’ following an inspection, leaving staff feeling shocked and unsure how to drive effective change.
But it’s not all doom and gloom. A study has shown how 10 GP practices used a poor rating as a way to propel their practice towards excellence.
The Care Quality Commission surveyed 10 practices that went from ‘requires improvement’ to either ‘good’ or ‘outstanding’ and published the findings on how they made significant improvements.
We took a look at the report and the changes the GP practices made.
Reacting to the report
Driving improvement revealed that all featured practices expressed shock and disappointment, or both, on receiving the report. They believed the care they were providing was good and that patients were satisfied. However, they soon understood where they were failing and most used the report as a basis for an improvement plan.
Some practices may already have had policies in place, so it was their priority to ensure they were properly implemented. They were able to be more strategic and look ahead. This meant that staff had to know about the policy and procedures, understand and follow them. For example, one surgery implemented a new way of handling annual reviews for people with chronic diseases which ensured that people were called into appointments.
The report noted that hard-working GPs, often affected by vacancies had not been able to find the time to effectively manage the practice on top of their clinical duties. Without an experienced practice manager, a GP practice will find it hard to operate effectively or achieve excellence. A good practice manager working alongside a senior GP is essential to the successful running of your practice.
Staffing and Training
The CQC report highlighted issues in regards to staffing and training. Problems ranged from poor uptake on training or it not being offered, staff unclear on their roles, lack of appraisals and poor recruitment procedures. To tackle this, one GP practice developed a list of mandatory training and highlighted what the staff members needed to do to progress. For example, training in dementia awareness for staff improved diagnosis rates.
Engaging staff members when making decisions that affect the practice was also marked as an important factor.
Teamwork and Communications
A team that pulls together leads to better patient care. Ensure that every member of your team understands their role and what each team is responsible for. Hold regular practice and individual team meetings. Ensure that every staff member feels heard and involved.
One case study employed task management software to help streamline processes and placed emphasis on using online systems rather than paper.
Another practice introduced new clinics and a staff rota which meant that patients would know which GPs were on duty that day. This was made possible by the skill mix of GPs.
Involving Patient and the Local Community
A number of practices benefited from working closely with the community. Use patient feedback groups to develop and improve aspects of your service. Survey your patients to identify gaps in service so you can take action and increase patient satisfaction.
Getting the Right Support
Almost all of the practices the CQC surveyed had sought external support. This was invaluable to smaller practices that didn’t have the resources available to make changes. Support came from a number of places including external consultants, clinical commissioning groups and NHS England’s Vulnerable Practice Scheme.
The report recognised the difficulty for smaller practices to deliver and sustain change. It stated how a number of practices found working in partnership or merging with larger practices provided an opportunity for collaboration and a wider range of services.
There is always room to strive for excellence and to continue making improvements, even if it’s not required on paper. The CQC report ignited a sense of ambition, determination and pride at many practices, which just goes to show, the work is never finished.
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