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Practice makes perfect

30 May 2013

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As a practice we had been aware of Royal College of General Practitioners (RCGP) accreditation programme and were eagerly awaiting its launch. 

The programme, which was created in collaboration with the General Medical Council, General Practitioner Committee at the British Medical Association, Royal College of Nursing, Care Quality Commission and Department of Health was an opportunity for us to assess ourselves against a national programme. 

Practices work very much in isolation and are not always aware of how well they are doing, often perceiving that they are not matching others in terms of quality and service. The practice accreditation programme, with just under 80 standards for us to measure ourselves against, was not just a way of benchmarking our achievements and making improvements, but also it gave the staff and patients some feedback on where we were achieving excellence. We felt that the £2,300 programme would prepare us for the Care Quality Commission (CQC) requirements that were on the horizon and realised that many of the standards in the accreditation were almost the same as for the CQC.

Initially when we went through the standards we felt like stepping away. As with any accreditation process if it was easy, the value at the end of it would reflect just that. 

As an early subscriber we found some problems with the administration and web site, but we were able to iron out early problems by talking to the RCGP, hopefully making the process simpler for those now undertaking the programme. It quickly became obvious that this was a team project, a whole practice project, not just something I could fit into my normal working day. It’s not just a matter of submitting a library of policies and procedures with review dates on them – we needed to show how we were using these policies and share experiences of when they had been used and how they had improved our service to the patients. This meant that every member of the practice team was involved in reviewing the policies and sharing experiences of where the policy had been used. Our Patient Participation Group was also involved to add the patient perspective to the standards. They were eager to be involved and as result we changed many of our practices’ policies so that they reflected the patients’ views as the receiver of the services. 

There’s also a time commitment to being involved in this programme. Each standard has to be broken down into components and often two or three members of the team would read through the standard to fully understand what the requirements are. 

In the initial stages we thought we had to work through the standards in the order they were presented but soon learnt this was not the case. Early wins are the key and so some of the easier standards were tackled first to enable the team to have a process in place for submitting them on to the RCGP website to be checked. We were lucky we had a member of the team who has excellent IT skills and was able to upload the policies, cut and paste items from minutes and practice leaflets, among other places. If that had this been left to me it would have taken hours, but to a young IT brain it was easy.

From then on the work was distributed to the most relevant person. As practice manager I got the HR section. The first few standards were straightforward, no problems – the information was already in the practice. Then I got one that referred to a particular document and process called DL07. No problem I thought, as I began to search the internet and asked various HR departments. But for some reason it had not been heard of. Reluctantly I gave in and asked the RCGP. After a week they came back to me a little bit red faced to say that they didn’t know where that particular standard had come from and apologised for it being in the standard. The joys of being first in a programme!

The whole process took us about nine months but it’s possible we could have done it far faster had the problems with the web site not held us up. We were appointed a very nice assessor, Debbie, who was also new to the process. In the early stages standards were being submitted without being passed through to Debbie for approval. Together we managed to improve this and hopefully those following will find that the assessment process is easy. 

As the assessments are reviewed some came back for minor alterations, simple things like review dates missing. We suggested in our meeting with the RCGP after we had completed the programme that maybe a Q&A section could be added to the web site so that practices can look at examples of how the information needs to be presented. 

We also suggested the practices who have been through the process can be approached by those just starting the journey, to talk through the requirements and possibly give some guidance in the early stages. I have already been approached by two practices and was very happy to answer their concerns and offer support if they needed it.

Without doubt Practice Accreditation has improved our quality processes and protocols. It gave us a chance to see our good points and our bad points and improve things. I think it makes you step back and take a reality check on what you think you’re doing and what you’re supposed to be doing, what kind of goals you should be trying to achieve.

We feel very assured that we are prepared for CQC registration and a visit from CQC inspectors. Moreover now the hard work is over we feel proud to display the Practice Accreditation certificate to our patients.

The benefits of completing Practice Accreditation are wide ranging, we feel the process developed the whole practice team, with revalidation on the horizon the GPs were enthused by the CPD credits they gathered, but moreover we do feel the Practice Accreditation certificate assures patients of safety and quality. 

Practice Accreditation requires hard work, a determined team and a leader focused on progressing the work. If you dedicate to the process the rewards are worth it.