The document discusses oversight of quality within primary care in Leicester, Leicestershire and Rutland Clinical Commissioning Groups (LLR CCGs). It outlines existing quality arrangements including peer review and executive leads. New opportunities from co-commissioning are developing quality indicators and a dashboard. Stakeholders have been involved to ensure consistency. The Primary Care Co-Commissioning Committee oversees commissioning and reviews the quality dashboard monthly. Escalation processes are in place where outlier practices are identified or individual practitioner issues arise. Data sources include QOF, CQC standards, and patient feedback. Practice engagement is sought on the dashboard.

1. Oversight of Quality
within Primary Care
Carmel O’Brien
Chief Nurse and Quality Officer

2. Existing arrangements
• General Practice Support Framework
• Peer Review
• Safeguarding Activities
• Regular practice newsletters
• Executive Leads - Carmel O’Brien and Dr Nick
Glover

3. New opportunities
• Co-commissioning brings new opportunities to monitor the
quality of primary care provision
• We are developing a suite of indicators and Quality
Dashboard reflecting Darzi dimensions of quality: clinical
outcomes, safety and patient experience.
• We have already involved stakeholders including local
clinicians, LMC, patient representatives via Healthwatch and
NHS England (NHSE) and our partner CCGs to ensure
consistency of approach for General Practice within LLR.
There will be an open discussion with Practices at an annual
visit to look at how the quality of care for patients is developing

4. Governance
• The Primary Care Co-Commissioning Committee
(PCCC) has a responsibility to oversee all
arrangements for the commissioning of primary
care medical services
• The primary care Quality Dashboard will be a
monthly feature which is reviewed at the PCCC
• The PCCC will provide summary reports to the
Governing Body for information based on decisions
made

5. Escalation
• The CCG does not have a role in monitoring or
investigating individual practitioner performance, this is
the responsibility of the Medical Director of NHS England
• Where a CCG member becomes aware of an issue that is
specifically related to an individual practitioner
performance this will be escalated to NHS England, for
example:
• Allegation of abuse of an individual – this would also
trigger a safeguarding investigation
• Whistle blowing from an external agency which
requires further investigation such as fraud

6. Escalation
• Where a practice profile shows a number of areas that
are outliers compared to other practices, we will adopt a
supportive style to understand the issues and formulate
a plan to improve. A stepped approach will be adopted
to provide support and gain understanding of practice
specific issues
• We will also escalate where necessary to NHS England
and Quality and Safety Committee
• There is consistency of approach across Leicester,
Leicestershire and Rutland CCGs

7. Data sources
• QOF data publicly available but only from the
current validated year. CCG may ask practices for
up to date current un-validated position
• Other data sources are local and will be held with
the Primary Care team - options include:
Care Quality Commission
Standards
NHS England General
Practice Outcome
Standards
Infection control and
incident reporting
processes
Listening Booth Complaints NHS Choices
GP Support and
Investment plan
NHS England GP
Patient Survey
Feedback from local
Healthwatch, PRGs,
PPEG

8. Draft dashboard

9. Engaging Practice
Membership
• We want practice membership engagement in the
types of data used in the Quality Dashboard analysis of
a practice picture of quality
• We will be honest and transparent with practices about
what data is held at practice level
• We are seeking their ideas about what will work best to
ensure outcomes, safety and patient experience
• This will form part of the Locality discussions during
July

10. Oversight of Quality
within Primary Care
Questions?