Scaling down your risk

Clinical Risk Education Manager Diane Baylis explains how our risk education team can support GP federations and other organisations working at scale.

The risks in primary care are not always related to clinical practice, but can be due to deficiencies in systems, communication, equipment or training. Managing these risks is of paramount importance, not just for individual general practices, but also for larger groups of practices, such as federations, in order to reduce harm to patients and staff, and to improve the quality of care provided.

For many years Medical Protection has offered a range of risk education for single practices. From workshops for the practice team on topics such as medical records or dealing with adverse outcomes, to consultancy tools and assessments that identify risks in areas such as infection control and repeat prescribing and provide advice on how to eliminate them.

Now, as general practice changes, and many organisations ‘scale up’ into GP federations and super-practices, we have similarly grown our education offering to provide risk management advice and support for the unique risks that these new, larger organisations face. 

Repeat prescribing support for NHS Lambeth CCG

In 2015 we worked with NHS Lambeth Clinical Commissioning Group (CCG) to deliver repeat prescribing support visits to 48 GP practices in the locality. The practices that participated were provided with a report and an action plan of recommendations. In addition, an overall written report was sent to NHS Lambeth CCG Medicines Optimisation Team.

As a follow-up to this project, we were invited to deliver further support to practices, with the aim being to reduce the overall risk relating to repeat prescribing across the GP practices in the locality. This was facilitated between January and March 2016.

Those practices who had indicated completion of some of the recommendations detailed in their repeat prescribing reports in 2015 were offered a telephone support contact, while those practices who had not indicated any progress towards completing the recommendations of the initial report were offered a further practice visit.

The support visits involved a two-hour visit to the practice to discuss with the practice manager and/or lead GP:

• the progress made following the initial risk assessment in 2015
• any outstanding areas of risk
• identification of barriers to implementing the follow on action.

The aim of the project was to reduce the risk relating to repeat prescribing in GP practices across NHS Lambeth by 80%.

After the first visit in 2015 repeat prescribing risk across the practices was reduced by 19%. However, after the follow up visits in 2016 the reduction in repeat prescribing risk across NHS Lambeth grew to 87%.

At the end of the project a member of one of the practices said: “Having the second review and report was really helpful, as the recommendations were specific, clear and timely.”

A member of another practice said: “The two visits are excellent exercises in clinical governance and preparation for CQC.”