1. Portfolio/Number/Name :H/T 3 Scottish Primary Care Collaborative |
2. Programme/Activity: The Collaborative Approach is a tried and tested method, developed in the USA, which has been applied to a range of management challenges including healthcare systems in the USA, Sweden and England. This year Australia and Canada will also be using the improvement methodology. The goal of the programme is to assist primary care organisations to develop their capability to deliver rapid , sustainable and systematic improvements to the care they provide to their communities through a sound understanding and effective application of quality improvement methods and skills. The aim is to ensure that 90% of patients can access their primary health care routinely within one working day. Through proactively improving GP Practice appointment systems and developing robust contingency plans for GP holidays and absences, the number of DNAs (missed appointments) can be reduced and the number of days using a locum can also be reduced. |
3. Efficiency | 3.1 Current target; £m | | 2005-06 | 2006-07 | 2007-08 |
Cash | 0 | 0 | 0 |
Time | 6.52 | 6.52 | 6.52 |
3.2 Efficiencies delivered; £m | | 2005-06 | 2006-07 | 2007-08 |
Cash | 0 | - | - |
Time | 3.112 | - | - |
4. Accountable Officer for delivery | Kevin Woods |
5. Project Manager | Stephen Gallagher |
6. EGDD Portfolio Manager | Rowena Simpson |
7. Description of efficiency and actions to be taken | 7.1 What is the efficiency improvement? How will the efficiencies be made? More patients will be seen by practice staff thus reducing dependency on locums. The number of GP hours lost from missed appointments ( DNAs) will be reduced. Consequently there is an increase in the number of patient contacts (output) relative to input. |
7.2 What are the main actions that are needed to secure the delivery of this efficiency improvement? To secure the delivery of the efficiency improvement the commitment of participating GP practices is required to work through the Collaborative Improvement Methodology and to develop proactive models of care which involves developing call and recall systems for patients with Long Term Conditions e.g CHD, Diabetes. |
8. Associated costs | 8.1 Are there any development or redundancy costs associated with the delivery of this efficiency? This project was embarked upon to secure better patient access and was not embarked upon on efficiency grounds alone. Consequently any development costs will not be netted off the time releasing saving. |
9. Measurement | 9.1 What are the inputs that will be measured? The number of locum days a GP practice, who are participating in the SPCC, uses before and after implementing changes to its practice systems will be measured. The number of GPDNAs a practice, who are participating in the SPCC, experiences before and after implementing changes to its practice systems will be measured. |
9.2 What are the outputs that will be measured? The savings achieved from the reduced number of locum sessions used by GP Practices as a direct result of the contingency planning that they have implemented since joining the programme. The savings achieved from the reduced number of DNAs experienced by GP Practices as a direct result of the patient access improvements they have made since joining the programme. |
9.3 What is the baseline for inputs and outputs? The baselines are: - the number of locums and respective cost in 2004/05, and
- the number of DNAs in 2004/05.
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10. Quality cross-check | 10.1 What quality indicators are being used to ensure that quality of service is maintained or improved? Quality of the service will improve as waiting will decrease and practices will have the capacity to direct patients to the most appropriate member of the health care staff in a more efficient and effective manner. Local practices undertake patient satisfaction surveys routinely. |
11. Monitoring | 11.1 What are the arrangements for monitoring the delivery of efficiencies? The information on DNAs and Locums will be provided by participating GP Practices on a monthly basis via an online reporting system, which they would be using to monitor their progress in improving patients access to services and improvements in the management of care for people with long term conditions. Agreed procedures for recording the information in every practice would be used to ensure consistency and accuracy of the data recorded. Accuracy could be compromised if practices did not follow guidance on recording the data. |
12. Reporting | 12.1 What are the arrangements for reporting the delivery of efficiencies? The efficiency savings will be reported by calculating the savings from the data submitted by the GP practices as detailed above (11. Monitoring) on a monthly basis. This will then be entered into the quarterly Monitoring Returns |
13. Dependencies | 13.1 Explain if your efficiencies are dependent on legislation or other structural changes being achieved. There are no legislative dependencies Improving practice systems is the basis of the method. Practices are assisted in this by a project manager in order to identify alternative ways of providing care to patients. eg telephone consultations, Practice Nurse led clinics. |
14. Use of efficiencies | 14.1 How are the efficiencies released from improvement activity being used to improve front-line services? Funding allocations from SEHD to NHS Boards for primary care did not assume an increase in the number of patient contacts. Due to the nature of the project there is not time released, but time more productively applied. |