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Primary Care Networks


Standardisation across a PCN

If you want to achieve anything from collaborating to sharing staff, you need to standardise as much as possible from the ground up.

Imagine if every one of Tesco’s 7,000 stores had a slightly different policies, procedures and training. Managing quality standards would be a nightmare, and this principle applies even at a smaller scale.

Standardisation achieves:-

  1. Minimal duplication of effort
  2. Common quality standard for performance and contracts
  3. Exchangeability of staff and managers
  4. Efficiencies with resources
Shared and Roving Managers

Shared Managers can be full time or each Practice Manager making themselves available for say just a couple of hours every week to help others where needed.

Where finances permit, Roving Managers whether full time or part time will prove to be useful. These can easily be retired managers giving a few hours of their time to the PCN.

One full time Roving Manager should be able to look after 10 practices and maybe more if everyone has reached a good standard. Alternatively, 2-3 PCNs can band together to employ one Roving Manager between them.

Shared tasks:

  1. Troubleshooting
  2. Take up slack
  3. Emergency cover
  4. Manage staff training


Collaborative Quality Improvement

Organise a Quarterly PCN Compliance Review:-

Practice members can meet once a quarter to look at potential issues:-

  1. Iron out compliance anomalies
  2. Exchange ideas for preventions and improvement
  3. Agree an Action Plan for those falling behind
  4. Record the meeting as evidence of collaborative quality improvement
  5. Compile a report to the CQC inspector on status of the group, and improvement strategises.
  6. Raise questions for the inspector, if any
Manage PCN wide standards

Devise a strategy and system for managing performance across the PCN

Suggestions for systems:-

  1. A common risk register
  2. Common risk prevention system and strategy
  3. A central reporting system for the Key Domains

Manage your Inspections

Manage your local inspector

Establish a good professional understanding with your local inspector.

Agree some basic ground rules with the inspector. It will make inspections easier and will give them comfort about your PCN standards.

  1. Aim for a single/combined audit for the PCN – This allows collaboration and to prepare together
  2. Agree the standard: Show them your common system and agree what both sides should expect
  3. Explain your standard approach and how it works: Agree that this meets requirements and hear out concerns
  4. If you have a manager’s manual on compliance, submit this copy for the record
Sync your Compliance Calendar

Set up a Compliance Calendar so that your group works in a co-ordinated way.

You cannot manage group-wide compliance if each location is working on different things at any given time and to a time-scale.

Benefits of a common calendar:-

  1. Everyone is doing the same thing, so you can share resources
  2. Now you only need one single plan for everyone
  3. Easier to manage projects and targets
  4. Faster compliance with whole group events
  5. Entire group moves forward at the same pace, no one left behind
  6. You know exactly where everyone is at any time

Co-ordinating your calendar will cut down the planning and managing workload to a fraction because you only need to do one single plan and share with everyone.

When it comes to an inspection, everyone will be at the same stage, with the same compliance plan, so there's less to explain and more in common

Significant Event Audits and Revalidation with less effort

PCNs can take advantage of being in a group by pooling resources and having just one set of Significant Event Audits between them.

Common problems with organising SEAs:-

  1. Finding the topics to investigate
  2. Getting material together
  3. Co-ordinating discussions

Shared SEAs, a PCN-wide solution:-

  1. Create a common shared register of candidate topics
  2. Select the top 3-5 topics for all members to audit
  3. Share the material with everyone in the group at the same time
  4. Organise a single event to discuss this or each location does their own and shares the findings
  5. Exchange notes and findings with everyone

The aim should be to complete say 5 shared SEAs from a ready-made list of topics. Members have the option to tackle more at their option.
SEAs should be about both positive and negative events that we learn from, and a common misconception is that these should be “incidents” and negative events.

Benefits and Achievements:-

  1. A single SEA topic is now covered between 5-7 members
  2. Substantial time saving
  3. Achieves CQC compliance
  4. Achieves revalidation
  5. Demonstrates shared collaborative learning.
Just one set of Policies and Protocols

Imagine if Tesco made every branch draft their own custom their own policies and protocols. They’d all be similar but not quite the same, and you would never know if the standard of service was the same between one branch and another.

PCNs allow an opportunity to share a common set of policies, drastically cutting down the effort required to keep this up to date and demonstrating to the CQC that everyone is working to the same standard of service.

Benefits of a common standard:-

  1. Shared resources mean substantially less work
  2. Demonstrates shared learning and collaboration
  3. Collaboration demonstrates everyone is following best practice
  4. Nothing left for the CQC to review at an inspection
Create a central Risk Register

Working as a group, you now have 5 to 7 times the resources you had before.

Benefits of a central Risk Register:-

  1. Easier to identify incidents and provide proactive support.
  2. When things go wrong, a collaborative approach will get faster results to fixing things.
  3. Instant learning from other people’s experience instead of learning from own mistakes.
  4. Less stress and anxiety if you know help is at hand.
  5. Access to other people’s experience results in faster problem solving

What a Risk Register should cover:_

  1. Any incidents where something went wrong
  2. Record of actual harm
  3. Never incidents and near misses
  4. Remedial action
  5. Prevention measures, sharing, learning and improvement



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