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A Balanced Scorecard for General Practice

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How is it being implemented ? Barriers and issues. Improvements delivered as a result ? ... 'Chatter' around impending BSC. Accelerated retirement plans ... – PowerPoint PPT presentation

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Title: A Balanced Scorecard for General Practice


1
A Balanced Scorecard for General Practice
  • Andrew Ridley
  • Director of Primary and Community Care
    Commissioning
  • Tower Hamlets PCT

2
Overview
  • Why a BSC ?
  • How was it developed ?
  • Whats in it ?
  • How is it being implemented ?
  • Barriers and issues
  • Improvements delivered as a result ?
  • What next ?

3
Why a BSC ?
  • A Focus on our role as Commissioner
  • Variation in quality between practices
  • Are the poor always poor , or the good really
    always good ?
  • Support a move from anecdote to transparent fact
    base
  • Perception that current measures too vague (eg
    nGMS) or not robust enough (eg QOF)

4
Why continued
  • Random cycle of measures patient survey, QOF,
    access survey, premises audit, clinical
    governance visits, prescribing audits, CEG
    audits.
  • Rarely made public
  • Concerns about profit levels
  • To increase speed at which improvement is
    delivered

5
How ?
  • Informal discussions re lack of systematic
    assessment method
  • Build a consensus for change Medical Director
    and PEC Chair critical in leading this
  • Early (1st) Draft shared with LMC before any
    corporate discussions
  • 3 lengthy, and useful discussions with LMC

6
Howcontinued.
  • Process DPCCC, Med Director, PEC Chair wrote
    initial draft
  • Informally shared with opinion formers
  • Then LMC
  • Revisions agreed
  • Then PEC, Board and LMC again
  • Then final LMC for sign off.

7
Howissues
  • No objection in principle
  • Concerns re workload no relative measures,
    absolutes preferred
  • Absolute clarity around what is contractual and
    what isnt sought some debate about banding A,B,
    C
  • Full LMC involvement sought joint working group
    to manage implementation now agreed

8
So.Whats in it
  • Contractual requirements
  • HealthCare Commission standards and therefore
    contribution towards PCT targets
  • Access doctor numbers controversial
  • Patient survey measure
  • BCP
  • Results to be public and on PCT website

9
How is it being implemented ?
  • Mainly by PCT Commissioning Managers Desk based
    assessment followed by verification on quarterly
    practice contract visit
  • HCC self assessment submission
  • BCP template provided practice to complete

10
Implementation contd..
  • Partnership approach
  • Transparent approach
  • 3 key achievements
  • Established the duty to cooperate with
    development support the expectation of use of
    remedial notices and contractual termination for
    non cooperation or delivery the highest
    standards to apply to new contractors

11
Issues
  • Equity between contract holders nGMS, PMS,
    PCTMS, APMS
  • Equity with other Independent contractors.what
    about pharmacy and dentists ? And NHS providers ?
  • No single rating too crude
  • LMC would prefer regional approach

12
Improvements already ?
  • Chatter around impending BSC
  • Accelerated retirement plans
  • Some improvements more doctors, nurses, HCAs,
    new phone systems etc
  • Already a clearer picture of where there are
    systematic practice problems or PCT problems
  • Stimulated development in other areas, eg PCT
    provider

13
What next ?
  • Complete assessment
  • Make public
  • Focus management energy on Band C scores
  • Use Band A standards to inform APMS contracts
  • Review utility of measures and improve for
    2007/08
  • Introduce for other providers

14
Questions ?
  • Any questions ?
  • Suggestions for improvement ?
  • Andrew.ridley_at_thpct.nhs.uk
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