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How we revamped our practice procedures to win a quality award

Dr Martin Keeling explains how his practice team won a quality award for the second time

Our practice was one of the original training practices in Derby in the 1960's and we are lucky to have a practice team who is highly committed to the delivery of the best possible clinical care, for the mutual benefit of the practice and patients.

In 2003 the practice was awarded the RCGP Quality Practice Award. To achieve this accolade the practice must provide written evidence to satisfy all the criteria laid down by the RCGP, the written evidence is scrutinised by assessors who then arrange a day long visit to the practice to verify the written evidence and observe the practice at work. Only after all of this is complete can the practice be awarded QPA. Currently only 229 practices across the UK have received the award and of these only 36 have received re-accreditation.

After working for and receiving the award in 2003 the practice was under no illusions about the amount of work required to attain QPA, the criteria are updated regularly so the criteria had changed and evolved since 2003, presenting new challenges. Nevertheless the practice decided that QPA offered many benefits for the practice.

It was a challenge which if achieved reflects on the excellence not only of the clinical care, but administration, recruitment methods, induction programmes, teaching and education, accessibility, patient information and choice etc. The award is seen as rewarding the whole team, something the practice is proud of and something that reflects a quality of care significantly higher than in the QOF.

Having decided to embark on QPA the practice identified key lead individuals to co-ordinate the collection and written presentation of evidence. This group was given protected time to work on QPA and over an 18-month period of time the evidence was produced to fulfil all 150 criteria.

QPA requires such a breadth of evidence that many members of the team were involved in producing the evidence for particular criteria. Consequently the practice team grew a level of confidence in the service that they are providing for their patients, as although needing to provide documentation for each criterion it became apparent that many of the criteria to attain QPA were already easily achieved by the practice. Apart from the benefits of team building through QPA the other major benefit is developmental, the whole process ending with the assessors' written report highlighting areas of excellence, recommending the award of QPA, but also pointing out areas for practice development.

The award of QPA for a second time has therefore stimulated development in several areas within the practice, for example, the updating of clinical guidelines which are stored electronically on the practice intranet for ease of access by everyone and a system for regular review, practice premises development etc.

A benefit which we had not been appreciated when doing QPA was the reaction of the patients to our receiving the award with cards of congratulation and a feeling of pride from many patients that they are registered with a practice who have been awarded a quality award. These feelings are also reflected in the patient participation group.

For a practice wishing to embark on QPA there are several factors we would recommend; read the criteria and the evidence required before starting the process, make a judgement of how your practice performs against the criteria, if you answer ‘we already do that' or ‘we already reach those standards' for 75% of the criteria then QPA is achievable but only with wholehearted commitment from the practice team, this is an award for the whole team and the whole team need to contribute to its attainment and then need to enjoy the satisfaction of success. The lead members of the team will need protected time to produce the written evidence required and support from members of the team for specific information, documents etc.

Dr Martin Keeling is a GP at Park Medical Practice, Derby

Dr Martin Keeling

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