The Manchester Standard Presented by Karen O’Brien Associate Director Primary Care Commissioning

1. The Manchester Standard Presented by Karen O’Brien Associate Director Primary Care Commissioning

2. Context • NHS Next Stage Review • WCC – “Primary and Community Services: Improving GP Services” (2009) Practice Performance Assessment Benchmarking • Contract monitoring • CQC practice registration in 2012

3. Our vision is to transform primary care locally to ensure that the entire population of Manchester has access to consistently high quality primary medical services. Evidence has shown that high quality health systems and healthy populations require strong and effective primary medical services. We will achieve this by working with practices and by recognising that many practices are already performing to high standards and we are keen to promote and celebrate these successes. However, we also need to recognise that there is wide variation in performance across Manchester and as the leader of the NHS locally, we need to be clear that poor performance is unacceptable. Vision

4. What is the Manchester Standard? It is a balanced scorecard that will: • Promote quality and support improvement in efficiency and effectiveness • Detect falling performance early enough to initiate preventative action • Detect poor performance and provide evidence for improvement or decommissioning of services • Demonstrate where there is capacity for further service development • Showcase the need for remodelling and establishing new patient care pathways • Provide data and information for effective commissioning (including consolidating public health data, patient satisfaction levels, access and responsiveness information, QOF data, etc) • Demonstrate high quality of service to patients to inform access and choice

5. What Indicators does it include? Section 1 – measured annually Contractual & Statutory Requirements and Compliance: • Self assessment contractual framework • Business Continuity Plan – IQ Planner • Safeguarding – training arranged • Care Quality Commission – practice registration 2012 Safety – policy implementation, repeat prescribing Infection Prevention & Control Premises – CIAMS or audit

6. Key Indicators Section 2 - measured quarterly • 48 hour access – QOF • Cervical screening • Childhood immunisation – COVER & finance data • Pre – school boosters - COVER & finance data

7. Developmental / Aspirational Indicators Section 3 – measured annually • Extended hours • QOF • Influenza immunisations • BMI • Enhanced services

8. Banding criteria Each quality indicator will have a banding A, B or C, with the following meaning: • Band A Achievement well above the minimum standard • Band B Meets the minimum standard • Band C Does not meet the minimum standard – remedial action required

9. How will we implement the Manchester Standard • Continued joint working with the LMC and practices • Year 1 – focus on 17 out of 25 indicators • Contract visits – frequency would depend on the self assessment of the GMS /PMS contractual framework by the practice • Visiting programme to validate information • Emerging Standards & Performance Management Group will have a remit to agree a range of interventions / packages of support to raise standards • Escalation policy

10. Primary Care Programme Board Escalation PCT Performance Management Group Quality Emerging Standards Executive Group GP Information Group General Practice Governance Framework

11. Data extraction & Validation Data Extraction • Where possible data supplied by the practice will be kept to a minimum and will be extracted from external sources, e.g. EPACT for prescribing, COVER, QMAS for QOF. However where data sources are on GP clinical systems and need to be extracted the PCT can offer the secure data extraction service. Please note the evidence requested for this year’s QOF year end assessment has been kept to a minimum to ensure that there is the correct level of probity but to balance this with the evidence requirements of the Manchester Standard Data Validation • Every effort will be taken to ensure the accuracy of the information contained within the matrix. However if the practice has any concerns or queries these should be directed to the Primary Care Commissioning Team.

12. Time Table • Launch Manchester Standard 23rd June 2010 • Practice sign off data end Sept 2010 • Emerging Standards Executive Group July 2010 • Performance Management Group July 2010 • Implement support programme Ongoing • Recruit assessors Aug 2010 • Visiting programme Jan 2011

13. Thank you I would like to thank the following: • The practices for their initial input and enthusiasm • The LMC for their support in development and implementation • Liam McGrogan & Tariq Chauhan – Clinical Leads • Jane Jackson, Annette Waddell, Allison Hey – Quality Team • Graham Hayler, Carol McDermott, Patrick Godfrey and Kinsley Ikem-Ifudu – Database • Medicine Management, Public Health, Finance & Medical Directorate • The team from Tower Hamlets