Case Study - Practice in Crisis

What was the issue?

The 2010 / 2011 “Operating Framework” from the DOH identified - better access to GP services, higher levels of patient satisfaction and a reduction in health inequalities as 3 of the 5 Health priorities for the service overall.

As a result, GP practices are being increasingly scrutinised and held to account for their performance against these and other wider performance standards.

Healthskills were commissioned to work with a 6 partner inner city practice which was regarded as “failing” by the PCT and despite previous interventions had failed to sustain any real improvement.

What did Healthskills do?
  • One to one interviews were conducted with the Medical Director and Director of Primary Care at the PCT, together with all partners and the practice manager from the practice. This enabled the Healthskills team to distil the key issues and draw up an immediate action plan.
  • A full day meeting for all partners was led by Healthskills which focussed on 2 predominant key result areas:-
    • Firstly, a unique balanced scorecard for the practice which clarified the operational short term priorities which would ensure survival.
    • Secondly, a series of trust exercises designed to support relationships within the practice which had become seriously undermined.
  • A further series of “away days” for the practice have built on this progress and moved the practice nearer to a clear vision for its own future.
What is different as a result?

As a direct result of Healthskills intervention the practice is now meeting access targets and has moved from red to amber on a range of public health parameters.

Clinical team meetings have been re-instituted along with weekly meetings with the PCT to monitor day to day progress.

Staff appraisals and performance reviews are being developed with a view to being fully operational by April.

Each partner is now accountable for a key clinical area and action plans for each clinical area are being incorporated into the Practice Corporate Diary.

Sustainable Change

Managing performance in General Practice is an increasingly difficult area for PCTs but is likely to become more crucial as economic constraints start to impact.
Healthskills are able to provide a multi dimensional approach, essential for issues with this level of complexity.

An understanding of strategy, process, team dynamics and individual psychology is required to provide lasting and sustainable change.

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