Raising the quality of drug treatment beyond the national standards clinician s influences
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Raising the quality of drug treatment: beyond the national standards Clinician’s influences. Dr Chris Ford GP and Clinical Director SMMGP 4 th West Midlands Conference. What do we mean by quality. An essential and distinguishing attribute of something or someone

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Raising the quality of drug treatment beyond the national standards clinician s influences

Raising the quality of drug treatment: beyond the national standardsClinician’s influences

Dr Chris Ford

GP and Clinical Director SMMGP

4th West Midlands Conference


What do we mean by quality
What do we mean by quality

An essential and distinguishing attribute of something or someone

Degree or grade of excellence or worth

A characteristic property that defines the apparent individual


Quality in health care
Quality in health care

The achievement of optimal physical and mental health through:

accessible, cost-effective care that is based on best evidence

is responsive to the needs and preferences of patients and populations

is respectful of patients' families, personal values and beliefs


Quality and cost effectiveness of care delivered in primary care
Quality and cost effectiveness of care delivered in primary care

A systematic review of quality of care in general practice concluded:

‘The published research in the field presents an incomplete picture of the quality of clinical care’

But a substantial number of well-designed studies exist comparing care by GPs to that of specialists, which show

‘no significant difference in quality of care and health outcome for care delivered by GPs even when substituted for secondary care specialists.’

‘Primary care physicians are more likely than specialists to provide continuity and comprehensive care resulting in improved health outcomes’


Quality in drug treatment
Quality in drug treatment care

The achievement of optimal physical and mental health through:

accessible, cost-effective care that is based on best evidence

is responsive to the needs and preferences of patients and populations

is respectful of patients' families, personal values and beliefs

But quality of care vary with point of view and role

who may be patient, clinician, purchaser, or manager

Descriptions of quality also depend on:

clinical setting, patient expectations, and severity illness


Quality depends on point of view
Quality depends on point of view care

Depend on who you are:

Patient

Clinician

Purchaser

Manager

Also depend on:

clinical setting

Patient expectations

Severity illness


What have we had to help us
What have we had to help us? care

Frameworks

QuADs, DANOS, MoC, TOPs

Clinicians

Clinical guidelines

Roles and responsibilities

Appraisals

Toolkit

RCGP Certificate


What have been the constraints
What have been the constraints? care

  • Target driven culture

  • Risk aversive



Changing directions
Changing directions care

  • Less resources

  • End of target driven culture

  • Back to local priorities

  • PCTs out PBC in

  • Where to next?


Language old out new in
Language: old out, new in care

  • Delivery/roll-out

  • Investment

  • Demand side

  • Top-down

  • Target

  • Regional/national

  • State

  • Strategy

  • Evidence based

  • Partnership agreements

  • Stakeholder

  • Active centre

  • Implementation

  • Spending

  • Supply side

  • Bottom-up

  • Payment-by-results

  • Local

  • Society

  • Business Plan

  • Principles based

  • Post-bureaucratic state

  • Social Responsibility

  • Departments


What do we have as clinicians to help us
What do we have as clinicians to help us? care

  • Listening to patients

  • Education / Knowledge

    • RCGP Certificate

  • Code of practice

    • Clinical guidelines

    • Roles and responsibilities

    • Appraisals

    • Toolkit


What the toolkit says
What the toolkit says? care

  • Competencies necessary to meet roles and responsibilities

  • Joint working

  • Assessment & testing

  • Treatment

  • Support & HR

  • Care Plans

  • Policy


Clinician influences on quality
Clinician influences on quality care

  • Patient-centred care

  • Competent compassion

  • Flexibility

  • Firm but fair boundaries


What else do we need to do to ensure quality
What else do we need to do to ensure quality? care

  • Fight for patients rights

  • Leadership

    • Ensure that practice informs policy and commissioning


Working together
Working together care

  • Impossible to do alone


Summary
Summary care

Change is coming

An opportunity

Need to ensure quality in ourselves

Continue to fight for quality services for our patients



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