Ben Skinner, Lindsay FP Smith, Anthony T Wright
Background Many barriers exist to improving the quality of primary care. A range of initiatives have been tested in the past to achieve improvement. No one model has been found to be particularly useful or effective. All existing models have defects. Setting The old Somerset Health Authority area in the West of England, UK. Method Comparison of quality improvement schemes in the primary care organisations (PCOs), and with the new general practitioner (GP) contract quality and outcomes framework. Results The practice quality programmes of three of the four PCOs evolved from a core practice quality plan (PQP) produced by the old Somerset Medical Audit Advisory Group. They were funded to different levels, and have developed differentially over five to six years. The other PCO eventually opted out of the PQP system and has encouraged its practices to undertake the Royal College of General Practitioners’ (RCGP) Quality Practice Award. All practices within the three PCOs with PQPs participated in the last year reviewed. There ismuch overlap between the three PQPs, and also with the qualityand outcomes framework of the new GP contract. Conclusion The Somerset practice quality programme was an effective way of improving practice participation in quality activities within Somerset. Thus, practices in Somerset were well placed to achieve the quality markers of the new GP contract. Such a PQP should be attractive to other PCOs in the UK and could be used to encourage greater participation in quality activity, especially in terms of local quality initiatives. Background Many barriers exist to improving thequality of primary care. A range of initiatives havebeen tested in the past to achieve improvement. Noone model has been found to be particularly usefulor effective. All existing models have defects.Setting The old Somerset Health Authority area inthe West of England, UK.Method Comparison of quality improvementschemes in the primary care organisations (PCOs),and with the new general practitioner (GP) contractquality and outcomes framework.Results The practice quality programmes of threeof the four PCOs evolved from a core practicequality plan (PQP) produced by the old SomersetMedical Audit Advisory Group. They were fundedto different levels, and have developed differentiallyover five to six years. The other PCO eventuallyopted out of the PQP system and has encouraged itspractices to undertake the Royal College of GeneralPractitioners’ (RCGP) Quality Practice Award. Allpractices within the three PCOs with PQPs participatedin the last year reviewed. There ismuch overlapbetween the three PQPs, and also with the qualityand outcomes framework of the new GP contract.Conclusion The Somerset practice quality programmewas an effective way of improving practiceparticipation in quality activities within Somerset.Thus, practices in Somerset were well placed toachieve the quality markers of the new GP contract.Such a PQP should be attractive to other PCOs inthe UK and could be used to encourage greaterparticipation in quality activity, especially in termsof local quality initiatives.
