Building a GP workload observatory - and your chance to be involved

Professor Simon de Lusignan, Director of RCGP RSC

The RCGP Research and Surveillance Centre (RSC) is one of Europe's oldest general practice sentinel networks, and has a rich history of improving public health.

The RCGP RSC is extending its role, and is building a general practice 'workload observatory' - aiming to provide a picture of the workload and complexity of cases that we increasingly see in general practice.

Here, Professor Simon de Lusignan, Director of the RCGP RSC, discusses the potential of this new initiative to inform the day to day delivery of care and workload pressures for general practice.

What is the Research and Surveillance Centre, and why is the RCGP involved?

The College has run the Research and Surveillance Centre and its predecessor bodies for over 65 years – it started back in 1953 when the RCGP established the Records and Statistical Unit and the Epidemiological Observation Unit. Eventually the two units merged, and 60 years later in 2013 the Directorship moved to me and the RSC was born.

There are over 250 GP practices in the RCGP RSC network, of which 95% are 'extract ready'. We take twice weekly extracts from practices, and generate a weekly report on disease levels.

These reports focus on disease surveillance currently, but we've just started a new project which allows us to develop into an innovative and under-researched area.

What is the focus for this new project?

We are developing an RCGP RSC general practice 'workload observatory' – in a literal sense this will take the form of a national summary of the previous weeks workload pressures and trends. In the long-term, we're trying to answer questions around who is coming to see their GP, and track changing patterns of complexity and comorbidity.

What are your next steps for making this a reality?

We're developing a feedback platform for practices to ensure they get something positive and developmental from being part of the network. We also have a Practice Liaison team that are raising awareness of this new development, both with practices that are already in the network and new practices that may want to join as a result.

Why would new practices want to get involved at this stage?

For some practices it's about informing the future of healthcare. The research projects that we are involved with have a real tangible impact on the health of the public - for example, it was the RSC network that spotted the swine flu pandemic in 2009. This workload observatory is a great example of how the data from practices will enable evidence-informed decisions.

Practices also get something from being in the network; the opportunity to be involved in funded research projects is a great way to generate income. There are learning and development opportunities that come as being part of the network, whether it's eligibility for RCGP Research Ready® accreditation, Quality Improvement through feedback, or being part of a network of like-minded practices.

What does the future hold for the RCGP RSC?

Excitingly, we are building stronger links with research. The dataset has been used in some of the best journals recently, including Diabetes Care1, the Lancet2 and the BMJ3. We hope to build even stronger research partnerships in the future. We're going to keep expanding our activities, and expanding the network to enable this growth.

We are extremely proud of how far our network has come, and have plans for continuous improvement. If your practice wants to find out more – please visit rcgp.org.uk/rsc or contact MedicalDirectorRSC@rcgp.org.uk

References

  1. Woodmansey C, McGovern AP, McCullough KA et al., Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retrospective Cohort Study. Diabetes Care. 2017 Nov;40(11):1486-1493. doi: 10.2337/dc17-0542
  2. Williams R, Alexander G, Armstrong I, et al., Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK. Lancet. 2017 Nov 29. pii: S0140-6736(17)32866-0. doi: 10.1016/S0140-6736(17)32866-0
  3. Kumar S, de Lusignan S, McGovern A, Correa A, Hriskova M, Gatenby P, Jones S, Goldsmith D, Camm AJ. Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial  fibrillation: a population based study from UK primary care. BMJ. 2018;360:k342. doi: 10.1136/bmj.k342.

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