QUALITY PRACTICE
AWARD
Version 12 criteria (1 April 2009 to 31 March 2010)
Click on links to download criteria
Guide to undertaking QPA
Step 1 - Deciding to
undertake the Quality Practice Award
Step 2 - Applying for
QPA
Step 3 - Adviser
Step 4 - Preparing the
Application
Step 5 - Submission
Step 6 - Assessment Team Visit
Step 7 - Consent to View Patient
Records
Step 8 - Assessment Visit
Step 9 - The Award
Step 1: Deciding to undertake the
Quality Practice Award
QPA is a team award and involves the whole
practice including attached staff. It is therefore important that
the criteria are considered and discussed as a team before
embarking on the award. The criteria may appear a little daunting
at first but with careful planning and sharing within the team,
they are achievable.
There are QPA study days held for those practices who are
currently working towards QPA and for those practices who
would like to find out more information.
Step 2: Applying for QPA;
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Having decided to undertake the Award, you
should notify the relevant RCGP office. They will ask you to submit the
Notice of Intent to Apply (NIA) (download here) and a deposit of £1200
made payable to Royal College of General Practitioners, on receipt
of these RCGP will notify the practice of their submission
timetable.
This amount will be deducted from your
total submission fee of £3600 (list size under 5000) or £3900 (list
size 5000 or over).
We need to know if there has
been:
- a formal/serious complaint
against the practice or an individual doctor or nurse within the
previous 5 years of the NIA date
- an ongoing or unresolved
formal/serious complaint
- or one that arises during the QPA
process
Please follow the instructions
outlined here.
Step 3: Adviser
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Throughout the process you will have access to
a central QPA Advisory Service. This will provide you with advice
and support on:
- how to interpret the criteria
- how the criteria relate to your
practice
- how you might approach presenting the
evidence
- support with monitoring your practice’s
progress
- how you might approach presenting your
evidence
- support on deciding whether you are ready
to submit
- a check through your written evidence
prior to its submission for assessment
A "Getting Started" Guide for Practice working
towards QPA can be found here
Use the adviser as you go along, email
evidence as completed rather than in one large chunk. All contact
be found in the "Getting Started" Guide.
Step 4: Preparing the Application
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It is strongly recommend that modules 1
(Patient Centred) and 2 (Management of Illness) are completed and
sent to the adviser for checking no later than 6
months prior to your final submission date. Audits
included in these sections should, by this stage, cover at least
the first data collection.
All audits need to complete the full
audit cycle. You may find it useful to use the guidance as
a template (audit guidance). It is important to note
the difference between an audit and a survey.
- An audit is a measurement of the quality of
clinical or organisational performance.
- A survey is a one off data collection
exercise although it may contain comments on the findings.
The date that the audit was carried out should
also be stated. The second data collection must have been carried
out within 2 years prior to your submission of the
written material.
Guidance on
- Management plan (link)
- Case study (link)
- Undertaking the patient and carer interview
here
Please note that some criteria are nation
specific. These need only to be met if you are in the relevant
country. The country name (England, Scotland, Wales or Northern
Ireland) is highlighted below the criteria number.
It is hoped that the preparation of the
written evidence will be a team exercise involving as many
colleagues as possible. This provides a good vehicle for team
development and reflects the increasing multi-disciplinary approach
to general practice.
Step 5: Submission
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Applicants should present their final
documentation as if it were being sent for publication in a journal
or for a higher degree. The following is essential:
- all contents should be bound or securely held
within large folders and easy to access - do not
overfill
- the written evidence should be presented
typed in 12 CPI on A4-size sheets
- a new page should be used for each
criterion presented
- each criterion should be typed in full
followed by your presented evidence
- each page should be numbered and indexed
in keeping with the modules
- the use of poly-pockets and multiple
appendices should be avoided
- individual patients should not be
identifiable - this means that initials and/or dates of birth
should not be used
- the document should be proof read to
eliminate typing and grammatical errors
It is advisable to present your
submission in an organised and methodical manner so the assessment
team can easily access the information you provide.
The average submission is normally contained
within 1 or 2 lever arch binder(s). Throughout the compilation of
the written evidence it is suggested that you submit completed
modules to the adviser for checking. When the adviser considers
that the submission is ready for assessment, they will notify
you. At this point you should advise the relevant RCGP office, who
will then begin to arrange the assessment visit.
The adviser is only there to offer
advice and the final say on whether or not a submission is
satisfactory lies with the assessment team.
All practices should
submit a short practice profile (Maximum 5 sides A4) to
include:
- description of premises
- mission or vision statement
- list of doctors and staff who work in or
with the practice, including roles, gender, ethnicity and
responsibilities
- a note of any special features of the
practice
- a description of the demography of the
practice including list size, age, sex, social factors and
ethnicity
- list of any changes in the workings of
the practice since the written evidence was initially produced.
This is to allow the assessors to understand how the practice
functions at the time of the visit.
- if the practice has previously been
awarded QPA then the report from the assessors should be submitted,
together with a short commentary on how the practices has responsed
to any recommendations
Step 6: Assessment Visit Team
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The assessment team will include a lead
assessor and three other assessors. They will represent various
members of the primary health care team and normally include a lay
assessor.
When the team has been appointed, the RCGP
office will request that you send one copy of your submission to
each of the assessors. It is important that the assessors have
adequate time to prepare their assessment. Six weeks is required
between receipt of the written evidence and the visit date.
The office procedures manual should be sent to
an assessor nominated by the RCGP office, usually the practice
manager. Your practice should also retain a copy of the full
submission.
Occasionally the assessment team will
request some additional work on certain criteria from the practice,
delays in providing this information may result in the visit being
rescheduled.
On receipt of the application, the assessment
team will consider the submission in relation to the criteria. If
any areas require further work prior to the assessment visit the
lead assessor will discuss this with the central advisor and
practice. When the assessment team is happy that the criteria have
been met, the visit will go ahead.
Step 7: Consent to View Patient
Records
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The RCGP has decided it may not be sufficient
in accordance with the law for patients to opt out of giving
permission for their records to be inspected. Recent codes of
practice, although they cover purposes such as the Quality and
Outcomes Framework, do not cover QPA assessment visits.
If anonymity is possible, for example by the
use of appropriate IT software, then this should be utilised. Where
not possible the consent of a minimum of 50
patients should be sought. All permissions should be
sought not more than one week prior to the day of the
visit.
It is advisable to inform patients that
permission may be sought for QPA assessors to look at their
records. On the attendance by the patient the consent should be
completed (download a patient
consent form here). The completed forms should be available on
the day of the visit, permission should be sought from a cross
section of the practice population.
Step 8: Assessment Visit
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The assessment visit is designed to be a
positive educational experience.
The RCGP office will liaise with the practice
to arrange a full day visit and a time-table will be agreed with
the practice (a suggested programme
is available here). Please note the assessor team will require
a room in the practice to work from.
At the start of the visit, each assessor will
sign a confidentiality form that will be retained by the practice.
Confidentiality will only be broken if a serious
breach of professional competence or fitness to practice is
discovered. The assessors will have a professional obligation to
report their findings to the GMC.
The assessment visit will include:
- a tour of the premises
- observing the front office
- examining the procedures manual
- statutory and contractual criteria will be checked where
appropriate
- a survey of the record system
- having the computer records explained
- interviewing the staff
- discussing the audits, clinical reports with
the medical and nursing teams.
It is expected that a potential QPA practice
will fulfil all their statutory obligations, which may be checked
at the visit. Any major breaches found may prevent the award being
made until they have been rectified.
At the feedback session, the assessment team
will inform the practice of whether or not it has been successful
in achieving the Quality Practice Award.
If the practice is required to complete any
additional work or documentation then achivement of award might be
deferred. Any deferred work must be completed within a timescale
agreed by the RCGP office. (maximum 6 months)
The assessment team will offer the whole
practice team feedback, which will include those aspects of the
practice visit that have impressed them most. Feedback might
include suggestions about how the practice might improve its
performance. A feedback report will be sent to the practice in
a typed format, usually within six weeks of the visit.
The assessment team will return all copies of your submission,
occasionally RCGP may ask to retain a copy, this will be stored as
confidential material for 5 years and returned to the practice.
Step 9: The Award
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Once RCGP has received written
confirmation that the practice has achieved QPA, the practice will
be contacted with regards to their plaque.
RCGP will also assist with arrangements for
the presentation if required. The award will remain valid for five
years, and the practice is also permitted to use the QPA logo on
letterheads etc., during this period.