Quality Improvement - COVID and beyond

23 October 2020

The COVID-19 pandemic affirmed the importance of agility in quality improvement across primary care. Throughout Scotland we naturally progressed cycles of change and improvement. The ability of primary care to adapt established novel processes overnight is commendable and testament to our resilience. What does the future hold from here?

It has been a year since we collaborated with the Scottish Government and partners to produce the National Guidance for Clusters (526 KB PDF) to support a foundation of equitable access to data and structure in quality improvement (QI). Things have changed so much since then, but the importance of our foundation remains.

WebEx series

RCGP Scotland has been co-hosting a WebEx series on the key topics of remobilisation with Healthcare Improvement Scotland/Scottish Government and they can be viewed again. With over 1000 attendees, they are popular and have excellent speakers. Topics have included: Near Me, delivering pharmacotherapy and long-term condition care, with the next event planned for November focusing on improving interfaces.

Remote consultations

Health care professionals are far more likely to catch COVID-19 because of the risk of occupational exposure (143 KB PDF). While acknowledging limitations in remote consultation, it remains the recommended, lowest risk option (1.5 MB PDF). As a College, we recognise that not all patients wish to see us in person for acute or long-term condition care. Remote reviews might be easier for some than for others and we note the favourable feedback on Near Me.

However, we are strongly of the opinion that there should be a range of different types of access available for patients and they should have choice. There is a risk that digital healthcare does exclude certain groups and we must work to combat this. We have co-produced Near Me primary care guidance (673 KB PDF) with more general guidance and continue to seek more evidence to develop a better understanding of these options.

Healthcare Improvement Scotland

Healthcare Improvement Scotland are refocussing their work on ACPs, care navigation, improving uptake of serial prescribing and Social Prescribing implementation. There is also a long-term condition network evolving, where we will support affirmation of the evidence to underpin what should be offered within a regular review within suitable time intervals. Moving forward we hope to expand and revamp the iHub case studies platform to allow ease of sharing of Cluster QI projects in a searchable database. This will allow improved QI collaboration across Scotland.

RCGP Daffodil Standards

I have undertaken work reviewing RCGP Daffodil Standards specifically from a Scottish perspective to support a future release which is more accessible to Scottish Clusters/Practices. If you previously considered these but chose not to start, we’d be interested in hearing your thoughts in this short survey, which only takes a few minutes to complete. Imminently there will be an accompanying module on providing EOLC in care homes, inclusive of Scottish considerations.

We continue to support national data sets including National Therapeutic Indicators for practice/cluster prescribing data (see the guide) as well as supporting a new platform for lab test use for each practice to aid QI activity.

As we return to normality, Scottish Veterans Care Network virtual launch is on the afternoon of 19 November 2020 virtually and you can register now. It will introduce the objectives of the Network and is an opportunity to shape the priorities and hear from key partners on the importance of the Network.

Quality Improvement is at the essence of general practice and primary care. QI must be given the time needed to implement. The time and resource invested pays dividends in quality and effectiveness of care thereafter.

Post written by

Dr Scott Jamieson, RCGP Scotland Officer for Quality Improvement

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