PCN Standardisation Programme

A Total Solution for Integrated Care

A single unifying Quality Standard for Healthcare and Adult Social Care

• Every provider works in exactly the same way, making collaboration and sharing seamless
• Meets DES requirements on Workforce, Collaboration, Reporting and Compliance
• Ready for Enhanced Care in Care Homes
• PCN members can easily support each other

Streamlined approach for maximum efficiency

The Approach

A "360º Workplace" approach where workload is shared through self-responsibility at all levels

A "360º Workplace" approach where workload is shared through self-responsibility at all levels, focusing on a culture of collaboration and teamwork. A bottom up approach addresses staff first, instilling a widespread and self-managing culture change from day one. Managers see an immediate reduction in their own workload and pressure.

With valuable time freed up, Managers can better focus on the next stage, a top down development of the Quality Framework at management level.

We have achieved this by designing a two part system:

• For Management: Quality Standards Manual that combines 6 separate frameworks from Governance and Policies to Revalidation and Evidence
• For Staff: Professional Standards Passport that encompasses all staff development in a pocket-sized diary, from Training and Knowledge to Policies; and Staff Appraisals to Personal Development

Observed Results and Achievements

Observed results

• Instant implementation; Up to 90% time savings for staff and Practice Managers; Dramatic reduction in duplication
• Average time saving of up to £12,500 per practice; Significant reduction in management workload; Greater teamwork and engagement at all levels
• Systematic approach increases Management Efficiency, speeds up Quality Assurance; Members are always automatically CQC inspection-ready; Cuts inspection times

The methodology and system have been so effective that support calls have dropped to virtually zero and Remote Support has become the norm, even for Practices in improvement measures. Practices and PCNs become fully self-sufficient, with no call for external consultancy or consultants.

Delegation with Teamwork

The key to delegation is making systems and content easy to understand. This provides clarity and confidence for team members to take on responsibility.

Pilots provided proof that even novice assistants in Special Measures were able to prepare and present to good effect at a CQC Inspection in a matter of days. Separately, practices were able to do an entire year's staff development, again in a matter of hours.

The systems become the hub of all activity where a single page can be used as a compliance briefing or as an agenda for a meeting, or for recording improvement. Most importantly, virtually anyone at any level in the Practice can understand it, manage it, and even present at an Inspection.

The Zero Effort Programme

Why this makes sense

Producing a common standard is immensely time consuming. Standardising the hundreds of policies and then creating a standard way of working will take at least 500 hours per PCN, equivalent to over £15,000. At the end of this exercise, every PCN will be working to a different set of standards and working in isolation to keep their custom standard up to date.

Why spend enormous amounts of personal time producing hundreds of documents just for your own PCN, when we could have one single National Standard for all PCNs across the country, requiring zero maintenance.

More Toolkits in the Pipeline

We are running a full programme to standardise hundreds of documents and processes. Participants can look forward to a full library of standardised Policies; Protocols; Risk Assessments; Standard Letters; Standard Forms and much more, applying our unique design methodology to all these so that everything is ready-made and easy to use.

Business Continuity

Most GP Practices are heavily dependent on just one or two people, usually the Practice Manager or Assistant Manager.

• This is a serious Business Continuity Risk
• Everything is customised so new Managers invariably start from scratch
• Reducing this risk is time consuming (Needs a detailed record of systems)

A Robust Common Standard Mitigates this Risk entirely

Adopting the Quality Standards Manual and the Professional Standards Passport as the primary Quality Assurance and compliance toolkits, this risk is virtually eliminated from day one.

Management Systems Risk Eliminated

• A fully documented system has been embedded
• Staff are already self-responsible, no change required

Change Management Risk Eliminated

• Immediate Peer support and "buddy" system across PCN
• Induction for new Managers literally takes 10 minutes
• Full independent support if required for new and existing team members

Professional Standards Passport

For frontline staff, we have combined educational, learning, and regulatory elements into a comprehensive risk based personal development tool. As software developers ourselves, even in this age of Apps and sophisticated online systems, we find that a book format is far more effective and the preferred learning format for frontline staff.

The Professional Standards Passport is a personal diary of experiences and learning for staff, a portable toolkit to carry wherever they go and used in all team meetings and discussions. This "user friendly" book requires no training and makes this low-tech solution far more engaging for frontline staff.

Our case studies show this has been immensely effective in taking the pressure off managers; staff instantly "getting" the concept of self-responsibility; and they record contemporaneous evidence of meaningful engagement between colleagues and managers alike.

The Quality Standards Manual

The Quality Standards Manual is a unifying system for Healthcare and Adult Social Care, developed by working closely with and currently used GPs, Dentists, Hospitals as well as Residential, Domiciliary Care and Agencies.

We constantly engage with CQC Inspectors, Social Service Auditors and other stakeholders for feedback on what works and what can be improved to make inspections easier for both Providers and Inspectors alike. Standards of preparation is improved with the clearly laid out targets and goals, and Inspections and Audits benefit from a structured presentation of the Provider's Quality Assurance processes.

Partnered with the National Association of Primary Care (NAPC)

We are partnered in this programme with the National Association of Primary Care (NAPC) who represent over 240 PCN members, comprising some 2,000 GP Practices.

Business Case & Funding

PCNs and Members are required to comply with the DES Contract

PCNs and the Members are required to comply with the DES Contract, with funding provided to meet specified activities.

Funding provided:

• Core PCN funding
• Clinical Director contribution
• Network Participation Payment

Most PCNs should be able to utilise this funding for this programme as The Quality Standards System is designed to be the fundamental building block for standardisation as a means to achieve Quality and Improvement; Collaboration; and Leadership at all levels.

Clinical Director's Responsibilities

DES Requirements Met

• Strategic and clinical leadership and implementing strategic plans
• Leading and supporting quality improvement and performance across Core Network Practices
• Operational delivery of services is a collective responsibility of the PCN
• Strategic leadership for workforce development, including development of a PCN workforce strategy

A Leadership Framework is an integral part of The Quality Standards System

• The design of Governance Framework and review methodology ensures that leadership, monitoring, and improvement activities are carried out in one single process
• This review typically takes no more than 10 minutes at regular Management Meetings, ensuring full Management Team participation

Workforce Requirements

DES Requirements Met

• Deliver integrated primary and community health care services … supported by an integrated workforce team
• Arrangements for staff employed by individual Members … can be expanded should Members so wish

The Professional Standards Passport

This instantly achieves both Mandatory and Optional Workforce objectives for every single member of staff in the entire PCN:

• A single source for Training, Policies, Appraisals, CQC Knowledge, CPD
• A single unifying standard for all CQC Providers including GPs, Dentists, Pharmacy, Residential & Domiciliary Care, and Community Hospitals & Hospices
• An integrated workforce throughout the PCN and any organisation that wants to join

Collaboration

DES Requirements Met

• We will work together to establish an integrated and collaborative team environment to deliver the activities and aims of our Network

Quality Management System Solution

You cannot impose collaboration through rules and protocols.

The Quality System uses a bottom up approach to effect an instant "Collaborative culture change" for both Staff and Leadership, so that collaboration comes naturally as part of daily routine and becomes our embedded culture.

• Providers benefit from substantial time and cost savings, and a more positive work environment
• PCNs will achieve immediate compliance with the DES Workforce principle

Compliance Monitoring

DES Requirements Met

The PCN must share data that:

• Supports compliance with the requirements of this Network Contract DES specification
• Benchmark and identify opportunities for improvement

In addition, Members should:

• Work together to establish an integrated and collaborative team environment
• Co-operate with each other in a timely and effective way and give to each other such assistance
• Share information with each other that is relevant to our Network

eManager System

We will be providing a secure Compliance Reporting System to allow remote monitoring of Key Compliance Matrices. This reporting will be integrated with the Quality Standards Manual. The system will allow remote monitoring and opportunities for proactive peer support for members.

Central Reporting System

DES Requirements Met

• Incidents that may impact on patient safety arises
• Potential breach of the Network Contract DES

PCNs are required to track individual incidents and events that may impact the DES Contract, and keep other Members informed. This is in addition to any action that may be required at Practice level.

eManager System

We will be providing a secure PCN Compliance Reporting System to manage:

• Incidents and untoward events
• Significant Event Audits
• Workforce incidents (Disciplinary, Grievances, Performance Issues)
• Central Risk Register

Enhanced Health in Care Homes

DES Requirements Met

• Work closely with Aligned Care Homes and ensure care is delivered in accordance with this Network Contract DES Specification
• Identify and engage in shared learning opportunities

Quality Standards System + Professional Standards Passport

• This is a universal system fully ready for Integrated Care and a common standard for both Healthcare and Adult Social Care
• All member organisations in the Network will follow the same Governance, Policies, Leadership and Performance Standards
• All staff training and development will follow a similar integration, enabling better coordinated learning opportunities for multi-disciplinary teams

eManager Software

• This is a smart compliance and data collection instrument
• eManager will provide a common reporting platform for sharing non-clinical, compliance and performance data