Although this exercise was originally commissioned as a one-off, we feel it is only worth the investment in time and resources if it is repeated regularly. It takes time to drive improvements in data quality, as well as build a culture of learning and enquiry for quality improvement. In the end, the goal is a fundamental change in the way people work, not a snapshot of how a practice is performing.
Finally, while this project was designed for individual general practices, to have clear ownership and control over their own data and reports, it also has the potential to deliver benefits at other levels. Some practices were interested in how comparisons with a peer group could work within practices. This could create a benchmark of clinical outcomes across the practice team, opening up a wider discussion about the potential for reducing unnecessary variation.
Other practices were interested in the opportunity for informing wider strategic commissioning, ensuring that STP and CCG plans are much better informed by accurate and current data. The project also created real opportunities for improvement. Too often, we tend to focus on the areas of activity that are easier to measure rather those that are most important. In the same way, this project tried to shift the focus from the quantity to the quality of consultations, highlighting that activity in itself may not always be good, but greater focus on continuity of care and longer consultations where appropriate probably will be.
It also considered how practices managed their workforce, exposing substantial variations in skill mix and the way they deploy their clinical teams to meet agreed goals. It provided the opportunity to seek out wider comparisons, not just with local peers, but with practices that are most alike – enabling those with atypical populations, such as students, to find a suitable comparator group.
One Care is continuing to work in this area. Medical director Dr Jacob Lee says: ‘As well as carrying out a refresh of this process, we are building our own business intelligence platform, looking at patient stratification and analysing telephony data. We are also engaging and supporting practices to standardise their data quality and management. We are building a culture that recognises the role information has to play in the transformation of general practice.’