The RAFT programme will help practices’ achievement on these new QOF Quality Improvement indicators (QI013 and QI014). Implementing the Access Actions is expected to improve wellbeing in the practice, through addressing both the volume and appropriateness of work, and reducing frustrations. All practices participating in the RAFT programme will be supported to assess their own situation and measure improvements in staff wellbeing.
The GP contract for 2023/24 introduced new Quality Improvement domains, one of which focuses on improving staff wellbeing through understanding the current situation, trying out improvements and measuring the impact. There are two ways in which this links with the RAFT programme:
- one of the major ways to improve job-related staff wellbeing in general practice is to manage workload better – for example, reducing frustrations, poor processes and wasted time, and making it easier to do the right thing for patients first time
- measuring job-related staff wellbeing is a key part of demonstrating positive change in RAFT
See also: QOF QI: reducing avoidable appointments
Requirements in QOF
This is a summary of the information from NHS England about the QOF requirements (p100 onwards).
- Indicator QI013. The contractor can demonstrate continuous quality improvement activity focused upon workforce and wellbeing as specified in current QOF guidance. 27 points.
- Indicator QI014. The contractor has participated in network activity (at least 2 PCN meetings) to regularly share and discuss learning from quality improvement activity focused on workforce and wellbeing. 10 points.
The focus of the indicators and associated points is on contractor engagement and participation in the quality improvement activity both in the practice and through sharing of learning across their network. This is to recognise that not all quality improvement activity will be successful in terms of its immediate impact upon patient care. If a contractor does not achieve the targets which they have set themselves this would not in itself be a reason to withhold QOF points and associated payments, unless they have also failed to participate in the activities described in the guidance.
Practices are free to develop their own improvement plans to address the priorities they identify. The QOF guidance provides some suggestions, but is careful to note these are suggestions only. It IS expected that practices will discuss their situation, opportunities and plans within the PCN, and that at least some of the improvement ideas will be based around PCN collaboration. It is suggested that the PCN discussions take note of opportunities in the wider locality and that they can be facilitated externally.
The ICB will require evidence (eg self-declaration) of the activities the practice has engaged in, the plans developed and the progress made so far. The key elements of the nationally provided reporting template are:
- What area(s) of workforce wellbeing did the practice identify for quality improvement?
- What was the defined “Smart Aim” of your quality improvement work
- What were the changes that you tested?
- What changes have been adopted?
- How will these changes be sustained in the future?
- What measures/indicators did you use to track your improvement?
- Did you observe improvements in relation to these measures/indicators? Please provide details of any improvements achieved.
- How did the network peer support meetings and patient participation influence the practice’s QI plans on improving workforce wellbeing?
How will RAFT help?
BSol practices who participate in the RAFT programme are expected to achieve full points for this QOF domain. There will be a minimal administrative burden, as the planning and reporting templates will be included in the project management templates used in the locality collaborative programme.
- Staff survey. The PSU will provide a staff survey that can be used by all BSol practices. This will assess job-related wellbeing, current workload and key aspects of staff’s employment experience. A free anonymous online survey tool will be provided for practices.
- Discuss and plan. One of the early RAFT forum meetings will have a special focus on staff wellbeing. Each PCN will review the findings from their survey and discuss opportunities for improvement. Standard templates will be provided for planning. Potential areas to consider will include:
- Improving wellbeing, resilience, and risk of burnout
- Creating a compassionate and inclusive culture
- Supporting the onboarding of new staff
- Supporting the training and development of the whole team
- Establishing peer support networks
- Improve and measure. Practices will implement the changes they chose to prioritise in the first of the RAFT forum discussions about wellbeing. They will be able to use the free BSol survey tool to measure the impact, for example after about 3 months.
- Discuss and plan. A second RAFT forum meeting, towards the end of the financial year, will include a special focus on PCN discussions about how things have gone so far, and what the priorities for action are in 2024/25. The facilitator will ensure this includes consideration of the ways in which PCN and locality working could improve wellbeing for staff, and how the PSU could support these.
- Report for QOF. The survey and templates used will provide each practice with a ready-made report for QOF reporting and CQC evidence.