Improving quality and safety in primary care

Overview 

Each primary care trust and individual GP practice has areas of risk that have particular relevance to the community they work with. However, many GP practices lack the experience and practical skills in implementing quality and safety improvements to make care safer for the people who use their services.

What are we doing? 

As part of our Closing the Gap through Clinical Communities award programme, 'Improving quality and safety in primary care' offers GP practices the opportunity to develop their skills and put in place processes for flagging up risk and preventing harm. This programme is looking at heart failure and high-risk medications.

We are working with a number of Scottish health boards, NHS Quality Improvement Scotland, NHS Education Scotland, RCGP Scotland and the University of Dundee.

We are also extending the programme of work with the same organisations as part of our safety beyond acute care work, which starts later in the year. This covers medication reconciliation, improving communication and developing safer systems.

What do the programmes involve? 

The part of the programme supported by Closing the Gap through Clinical Communities aims to support 80 general practice teams to identify and reduce risk and harm to patients registered with their practice. In the first instance, practices will be encouraged to focus on two specific areas of care:

• patients with heart failure, with the aim of making sure all patients are receiving reliable, high-quality care, and are trained in managing their own condition
• patients on high-risk medication with the aim of ensuring that they are reliably monitored.

The project sets out to improve quality through collaborative methodology and ‘small tests of change’ methods, as well as by creating risk registers and improving the identification, recording, reporting and analysis of adverse events.

Later in the year, the programme of work will extend to developing and testing change packages in the following areas:

• developing reliable systems for medication reconciliation at discharge from hospital
• developing reliable medication reconciliation after attendance at outpatient appointments
• improving clinical communication between specialist outpatient clinics and primary care to optimise shared management
• developing safe and reliable systems for managing results.

The programme will also build expertise, experience and knowledge within practices, boards and NHS Quality Improvement Scotland in developing patient safety generally and specifically in these important and underdeveloped areas.

The support provided by the Health Foundation covers:

• The heart failure and high-risk medicines programme is supported through Closing the Gap through Clinical Communities.
• The extended phase is supported through our safety beyond actute care work.