Nov 2020 Update

EQUIP still offers standard QI coaching (see our mission statement below) but due to Covid we are being asked more and more to help practices deliver a Digital Offer. This can be accessed within the Digital 2020 tab. We have therefore revamped the website to give some really practical help on:

Please click on any of the above digital offers for more information on how you can implement these within your practice.

We also know that staff are under a lot of pressure. We have therefore  updated our staff Wellbeing section to explain what support is currently on offer.  Please see under the Wellbeing 2020 tab. We really hope this is useful.

Please have a look at the new material and ask your QI coach or email the EQUIP team here for further help.

Our Latest Newsletter (27/04/2021)

Dear folks,

We know that people are feeling like there is super-high volume of demand at the moment.  This can be coming from a variety of sources:

  • Stuff that people have been hanging on to since the first lockdown
  • Extra registrations because people want to be on the system to get vaccinated
  • Vaccination queries
  • Work sent through from hospitals, who are feeling the pinch tightly
  • People on hospital outpatient and diagnostic waiting lists who are re-presenting to primary care

Our intention was to put together a quick snapshot of ‘reactive’ demand (contacts that are initiated, in the most part, by people wishing to access their GP practice with a question or concern about their health and care), looking at some sample practices from across North East London, which would give an idea of what is happening, and what ‘extra demand’ actually means – how much? From where? From who? etc.

When we took a look we found that after the dip experienced at the beginning of the pandemic, demand across primary returned to ‘pre-pandemic’ levels after the summer holidays, and has remained high since Christmas.  The weeks commencing 15th and 22nd March were statistical outliers a.k.a. “really *insert expletive here* busy”!!

Here’s the thing, though – the graph above only tells part of the story as it shows average activity across 8 practices.  In the attached mini-report there are examples of individual practices where demand is through the roof and other practices that show a different picture entirely.  The shift to new channels of access, like online/digital is also clear – making the demand feel different to before the pandemic.

One of the main challenges when trying to analyse the work done in primary care is that individual practices capture their activity in lots of ways – appointment slot types, users, consultation types.  Add to this that we have multiple new channels of access – from telephone and face-to-face through to online consultations, SMS, emails, carrier pigeon etc… and it becomes clear that measuring the same thing across practices isn’t straightforward.

In our sample, practices that measure more stuff, showed more demand. We are really keen on not letting demand ‘hide’, but on being able to build a fuller picture around what is actually happening.  So, our ask of you: please help us build a better picture.

Some things that really help with this are:

  • Mapping your appointment slot types to the National Standard Appointment Categories. Across NEL, we’ve worked on turning the national guidance into a straightforward process to save you time and get better data out too.  If you need help with the mapping please contact your local NEL CSU IT facilitators who are poised, like coiled springs, to support you with making this as painless as possible.
  • If you are an EQUIP practice and/or have Edenbridge Apex installed, and you need to refresh the configuration to capture new modes of access such as online/digital, please contact Sindbad on the EQUIP team or Ben Hampshire at Edenbridge who will be happy to help.
  • And finally, if you’re really up for helping to build a fuller picture of demand, we’re looking for a few practices to share some more detailed workload data with us.  What we’ll need (and this will require a bit of manual counting and server downloads) is some specific extracts of your data over a couple of weeks:
  1. Incoming telephone calls (from your telephone server or phone supplier)
  2. Volume of patient-related emails
  3. AccuRx data
  4. Other ‘hidden’ workload – daily documents, lablinks etc
  5. Capturing ‘avoidable contacts’ using a simple audit tool

In return, we will build a fuller picture of the demand (including failure demand).  By measuring and showing the work that is being done in primary care, we can make a better case for the resources needed to meet this demand.

Tom, Sindbad and Afzal

DOWNLOAD DOCUMENT Understanding demand in primary care

EQUIP – The WHY we should embrace QI

The EQUIP Mission Statement

Making Tower Hamlets the best place to work, and the best place to receive care.

The world of General Practice is currently under significant pressure. Across the board budgets are being cut, and resources constrained. ‘On top of this, practices face a rapidly growing population, thus in turn increasing demand for GP services. The growing population has different health needs from those of the past, forcing practices to re-evaluate the efficacy of their business models and clinical processes. As a result of these challenges, practice staff are under unprecedented levels of stress, leading to recruitment and retention challenges.

Our response to these conditions is to roll up our sleeves, and address these issues head on. The EQUIP (Enabling Quality Improvement in Practice) programme is designed to do just that, by providing practice staff with the tools to create meaningful and lasting change. This is done by allowing practices to work on what matters most to them through a tried and tested Quality Improvement methodology. By doing this, we hope to improve the lives of staff and develop a culture within practices that values bottom-up change and continuous improvement. We also hope that we will make General Practice resilient and effectively able to manage current challenges and variation, and lead change so it can deliver even better care to patients in the future’.

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