Capacity and Access Framework

Thinking about the upcoming Capacity and Access Framework for general practice. It seems likely that they will base this on a) patient experience b) ease of access and c) data upload/quality (i.e. GPAD) to measure the latter at least - in many ways this is fair enough - but the rumours are you will have to agree a baseline with your commissioner then demonstrate an improvement… which sounds fine but what about those practices doing well.

I’ve just been looking at my RightCare data and in the patient experience modality - my PCN beats its 20 peer PCNs in all indicators so how am I going to improve?

Ok you might say if 95% are happy maybe I should aim for 99% - well.. ok.. but 2 things:

1. Can I remind people about the concept of regression to the mean… where extreme results tend on repeated sampling to return to more normal (average) results.. so those in the top quartiles will tend to reduce and those in the bottom quartiles will tend to improve just from statistical sampling.. and
2. You cant please all of the people all of time - if I’m getting high scores - am I really going to be able to improve them? and potentially given the sample size a small number of discontents could dramatically alter my funding.

So we could be in danger of failing to reward successful practices and putting money into poor practices who haven’t really done anything to deserve it - we could also be basing funding of practices on a small minority of users who are engaged in responding more likely those with a gripe.. Perhaps this is what they want.. but is it right?

We need our commissioners to take an intelligent approach to this - and understand the limitations of the methodology. We need agreed plans based on concrete demonstrable actions not hampered by statistics.

Am interested to hear from other PCNs are thinking about putting in their plans.

Also I strongly suspect the money will be paid at PCN level…. under the previous IIF - many practices agreed to split income by fair shares and there were issues where not all did the same amount of work - are practices with different access issues going to be happy to do this? What about a PCN where one practice currently scores really highly and one really badly.. one might do all the work to improve - who should get the money…?

#patientexperience#data#primarycarenetworks

View discussion on LinkedIn →