A new framework document published by a little-known programme board may quietly represent a significant step forward for person-centred primary care.
The ‘Shared View of Quality in General Practice’ unites all 11 bodies who commission, regulate and provide professional leadership for GPs. It is partly intended to enable a single ‘system view’, allowing performance data to be streamlined, and thereby reducing the reporting burden on practices.
The definition of quality
It also advances the definition of ‘quality’ in several ways. As one of only two outside bodies invited to contribute, National Voices objected to merely consolidating existing indicators, and supported the Royal College of General Practice to bring in new domains from its own statement of quality, published a year ago.
These new elements do two things. First, they introduce specific aspects of person-centred care. Second, they look forwards to GPs’ key role in future healthcare systems, using integrated population health approaches as envisaged by the new models of care and the emerging Integrated Care Systems.
So, whereas the existing definition of a ‘positive experience’ for patients revolved around compassion, now it includes:
“Supporting patients to take control, understand their choices, set and achieve their goals by assisting them to gain the knowledge, skills and confidence to make the right decisions for them”
It asks for continuity of care, so that “patients feel that their clinicians know about and understand them and the context that they live in”.
It introduces coproduction, through “empowering patients and their carers to become equal partners in the co-creation of local services”.
Personalised care and support planning
The RCGP has been the most proactive professional body trying to develop personalised care and support planning, and this is recognised for the first time as key to quality, with GPs expected to have ‘the knowledge and skills’ to deploy it ‘to provide person-centred and coordinated care’.
On a wider canvas, ‘effective’ care now means not only giving the right treatments, but ‘supporting the health of the registered population’, including reaching vulnerable communities to reduce inequalities, and working with local partners including the voluntary sector on coordinated care delivery.
Together, the indicators in this new framework should help align national bodies around approaches long advocated by National Voices members.
The next step towards embedding these approaches will be the conclusion of NHS England’s review of the Quality and Outcomes Framework, to which we have also contributed and which is due this summer.