GP Provider Support Unit, Birmingham and Solihull

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Right Access First Time - locality collaborative for BSol North practices

All-practice meeting, Thu 30 November 12:30 - 4:30pm. Brook Marston Farm Hotel, B76 9JD

About Improvement Collaboratives

Improvement Collaboratives are a tried and tested approach to primary care development which allow practices to make better improvements with less effort. The approach will already be known to practices who have participated in national programmes such as Time for Care and Productive General Practice Quick Start.

An improvement collaborative is a group of practices who are working on improving a similar aspect of their work – in this case, access. The collaborative meets regularly to share examples of what’s working, solve problems together and develop the next stages of their plan with expert support. The combination of pooled expertise and practice-to-practice sharing of effective solutions helps each team to make more effective changes with less effort than if they did all their work in isolation.

The RAFT programme is facilitating a collaborative for practices in each locality of BSol. We will meet roughly every 6 weeks or so. 

The agenda is set by practices themselves, to ensure we address the top priorities locally as well as national requirements such as those in the QOF QI indicators on access and staff wellbeing

Priorities for North locality practices

At our introduction meeting in the summer, GPs and practice managers in the West locality reviewed the options for improving access and managing workload and discussed the top priorities for action in 2023-24. 

The document below summarises the discussions from our last meeting. 





Right Access First Time update



Case study – total triage at Greenridge surgery



Triage pathway (view / edit)

Audit on avoidable appointments

Most practices find that a significant proportion of GP / ANP appointments could have been avoided. Measuring this – and the specific changes that could be made – is very helpful in identifying your priorities.

The PSU is developing a free audit tool to support the collection and analysis of this data, to inform your discussions and plans. This will contribute towards your QOF achievements in 2023/24. 

Read more

Demo of the audit tool

Demo of the results dashboard

What do you think?

Locality decision making

In the meeting we will review and discuss the proposals developed by the locality leads for how we will approach decision-making for locality-wide issues in the North.

At our last all-practice meeting, GPs and managers gave detailed feedback about the way communication and decision-making should happen when the CDs discuss whole-locality issues. You asked for:

  • Good communications to practices, allowing PMs and partners to choose how much information they read regarding locality issues (ranging from ‘the headlines’ to ‘enough detail to be able to give an opinion’).
  • Good communications from practices, enabling those who wish to make a greater contribution to decisions about issues in the locality and BSol general practice as a whole.
  • Clarity about how and why decisions are made.
  • A balance between every practice having to be closely involved in every discussion or decision, and practices delegating all authority to PCN CDs without further involvement.
  • The opportunity to review and vote on specific options for any proposed clarified or changed decision-making arrangements.

Guiding principles:

  1. The PCN Clinical Directors (CDs) serve member practices and seek to be informed by practices in their decision making.
  2. As a collaborative network we wish all practices to have the opportunity to contribute to decision making. This requires good communication and transparent decision making.
  3. We also wish to avoid overburdening practices by expecting them to have to contribute to every aspect of locality decision making. 

Proposed decision-making approach:

  1. Each CD is responsible for ensuring their member practices are well-informed about initiatives and issues being discussed in the locality and BSol general practice, and that practices’ ideas and views are fed back into those discussions. CDs will be supported in this by the locality clinical lead and the GP Provider Support Unit (PSU).
  2. Most decisions will be made in the monthly Locality Leadership Meeting, attended by all CDs, with the locality clinical lead and the PSU’s locality manager.
  3. Decisions about locality wide initiatives will be taken on the basis of weighted vote by practices, proportionate to list size. In most cases, each practice’s vote will be conveyed by their CD. In some cases votes might be cast by other means such as an online system.
  4. A decision will require the support of:
    • at least two-thirds or three-quarters [to be discussed with practices, 7 December] of votes; AND
    • the support of at least 4 of the 6 PCN CDs [to be discussed with practices, 7 December.
  5. The outcome of all decisions will be communicated promptly to practices. 

In the event of a decision needing to be made quickly, the following process will be followed:

  1. information will be sent directly to all practices by email, indicating that it relates to a time-sensitive matter
  2. CDs will offer to host a virtual meeting with practices for discussion
  3. practices will be invited to contribute ideas and views in an online format
  4. an online vote will be taken with a decision being made on the same basis as above – that is, requiring the support of:
    • at least two-thirds or three-quarters [to be discussed with practices, 7 December] of votes; AND
    • the support of at least 3 of the 5 PCN CDs [to be discussed with practices, 7 December. 
Please discuss this in the practice, ready to let your CD know your preferences 

Action planning

Below are 3 planning templates, for different levels of detail. Select the one that suits your current situation best.