Informatics for Improvement
Data to support improvement activities in GP Clusters
What we know
The GP contract in Scotland has changed, with a focus now on quality improvement through collaborative work in new 'GP Clusters'. GP clusters are groups of 8-12 practices working in the same area who meet regularly to collaboratively identify and address aspects of care which need improvement.
The Scottish School of Primary Care reviewed the literature on the effectiveness of this kind of approach, and a key element of success is how clusters access and use data about the quality and safety of care. NHS Scotland recognises that in order for GP Clusters to function as intended, they need support with data analysis; but it is unclear what their data needs are, or how best to provide them with data.
To explore how GP clusters access and use data to support improvement activities.
What this research explored
This qualitative study examined current improvement work and use of data in Scottish GP clusters, with a particular interest in whether and how quantitative data (for example, from platforms such as the Scottish Primary Care Information dashboards and Care Information Gateway) was used for improvement.
What this study added
There was uncertainty as to whether GP clusters should focus on activities generated internally or externally by the wider healthcare system (for example, from Scottish Health Boards), although the two observed clusters generally generated their own ideas and issues. Clusters operated with variable administrative/managerial and data support, and variable baseline leadership experience and QI skills. Qualitative approaches formed the focus of collaborative learning in cluster meetings, through sharing and discussion of member practices’ own understandings and experiences. Less evidence was observed of data analytics being championed in these meetings, partly because of barriers to accessing the analytics data and existing data quality. Cluster development would benefit from more consistent training and support for cluster leads in small-group facilitation, leadership, and QI expertise, and data analytics access and capacity. While GP clusters are up and running, their impact is likely to be limited without further investment in developing capacity in these areas.
It is hoped that these lessons can be translated to support GP clusters across Scotland and will inform the ongoing developments of Scottish Primary Care Information Resource (SPIRE) and the central role it plays in supporting GP practices in their local improvement activities.
This project is led by Professor Bruce Guthrie, Professor of General Practice, University of Edinburgh, in conjunction with colleagues from the University of Dundee, NHS National Services Scotland and Primary Care Cluster staff.
Huang H, Jefferson ER, Gotink M, Sinclair C, Mercer SW, Guthrie B. Collaborative improvement in Scottish GP clusters after the Quality and Outcomes Framework: a qualitative study. Br J Gen Pract. 2021 Apr 1:BJGP.2020.1101. doi: 10.3399/BJGP.2020.1101. Epub ahead of print. PMID: 33798092.
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