NHS Digital - Quality Assurance Through Automation

• 10 PCNs in SW London
  
• 17 individual practices
• 62 Total participating Practices

1. Our aim is to eliminate laborious paper-based processes and establish common and shareable high-quality processes through automation and workflow technology. This will allow all participants to acquire pre-set minimum quality standards “out-of-the-box” and perform to the same standard as an expert manager.

This will also make it possible to achieve and be certified to a recognised level such as the International ISO 9001:2015 standard with less effort, and act as a benchmark of assurance to minimise the burden for CQC Inspectors.

This project will address the following: -

• Automatically addresses CQC Compliance
• Structured management of Processes, and Protocols
• Risk management
• Team engagement, specifically Well-Led and Leadership
• Standardised performance standards across the PCN and potentially ICSs

Peer Support Network

A common standard and common practices are essential building blocks for collaboration and efficiencies at scale. Digitisation will provide risk measured performance data, which can be used to pinpoint weaknesses to effect improvement.

Based on a centralised and real-time record of activity, we intend to introduce new ways of support and collaboration at PCN level.

This will include: -

• Proactive member support as events arise
• Sharing expertise and resources to lift least resourced members
• Easier staff secondment to share good practice, knowledge, and skillsets

PCN Level Management:

• Focused team interactions based on actual performance and issues
• Improved collaboration and sharing of good practice
• Learning opportunities through shared incidents and SEAs through central reporting
• Targeted quality improvement experiences and strategies

Quality Assurance & CQC Inspections:

• Explore and develop Peer Review Audits
• Evidence collection to pre-empt CQC Inspections
• Risk measured Compliance, performance, and improvement

Engagement with ICSs and Local Authorities:

The proposed system has the capability of “Channels” for other Stakeholders, which can be workflow Apps or simple data collection instruments, Examples of usage are:-

• Interactive Safeguarding and Incident management Apps with real-time direct reporting and management to LA/ICS level as required. Providers can submit incidents and interact with Care Service Managers, with full reporting and analytics built in
• Ad hoc secure data collection (e.g. expanding on what we learnt about local data reporting required during pandemic)

1. The current Quality Process
   • GP Practices and other Providers work in silos, purchasing non-integrated compliance products from disparate suppliers
   • Each practice creates their own systems to their personal preferences and following their own methodology depending on experience and preferences.
   • Quality Assurance is generally assumed to be synonymous with managing and extensive library of policies.

2. Limitations of the current process
   • Typically, all compliance and Quality Assurance is vested in the Practice Manager.
   • The system is heavily reliant on time and skills available to one individual manager. This creates a single point of failure, posing a very high risk both to the performance standard and business continuity.
   • Current methodology and design are based on laborious document management discourages Senior Management and Partners from participating in the Quality Assurance process This negatively impacts Well-Led, Governance, and Leadership objectives.
   • There is considerable duplication of effort across the board, estimated at some £15,000 per practice, but Practices often don’t have the motivation, knowledge, or resources to take advantage of economies of scale
   • The lack of a common standard, documentation, and work practices, adds a layer of difficulty in sharing and collaborating on anything from Best Practice to staff management

Business Continuity Risk:

• There is considerable pressure and stress on Practice Managers, with some 50% indicating their intention to leave the profession. Replacing a manager can cost up to £25,000 in time and disruption.
• A new manager, when faced with studying say 300 partially customised policies, will find it easier to scrap the entire system “personalised” by the previous manager, and start from scratch with standard policies as the baseline.

1. Benefits for workforce

The key benefits of this system are: -

• A single system for all Quality Assurance data, processes, and protocols. Everything in one place
• Focus on Well-Led, Leadership and Governance, arguably the most difficult to prove at an inspection
• Central repository of all Best Practices, processes, and protocols
• Fool-proof processes, everyone gets it right first-time-every-time
• Time, costs, and efficiencies. Always up to date, zero time wasted on updating policies, processes, protocols
• Foundation for “Big Data” and granular data for performance benchmarking
• Secure cloud data storage, not easily visible or accessible to malevolent parties

Benefit for PCNs

PCNs will achieve instant economies of scale with zero effort. Their library of common Best Practices is maintained centrally with automatic updates.

Setup takes minutes, and the system is simple and intuitive, taking a couple of minutes to learn.

1. Benefits for Patients

Automation will free up Practice Managers, the most valuable member of the team, for more productive tasks.

Standardisation of Best Practice and streamlining of processes will provide consistency of service quality. Patients can be assured that their Provider is adhering to a high-quality standard on a continuous basis and not just at a single point in time of the CQC Inspection.

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