Introduction to Quality in Primary Care

Quality improvement is the process by which individuals and teams, through self-reflection and benchmarking, identify and then look to address areas of for poor or variable quality, as well as stronger areas that could be improved further. Quality assessment can take different forms and uses various tools to appraise the standard quality of particular aspects of general practice care.

As part of taking on full delegation of primary care co-commissioning from 1st April 2016, the CCG has had a statutory duty to assist and support NHS
England with quality of services in primary care and the delegated authority for contracting primary care services. The Primary Care Quality Assurance Strategy, shared with practices last May, outlines the overall approach to quality assurance, with concerns about quality being reported to the Quality and Patient Safety Committee and, if necessary, escalated to the Primary Care Commissioning Committee.

With the release of the Primary Care Matrix tool to practices at the start of this month, the Primary Care team and the Performance & Intelligence team will help practices identify areas where quality indicators might be improved, and support conversations and the development of action plans to address these where necessary. We fully understand that there are often rational explanations for this, which can be completely outside of the control of individual practices but the reasons need to be explored.

Zara Head (, 01302 566318) has been working as our Primary Care Quality Nurse since last year and has been supporting practices in their hard work to maintain and improve quality and patient safety. Her role includes:

  • working closely with practices following an inspection by the Care Quality Commission who have received an overall rating of requires improvement or inadequate or where any domain or population group has received a rating of requires improvement or inadequate, to support action planning and how quality improvements can be made and embedded.
  • supporting practices with a rating of good and outstanding to maintain and continually improve patient, carer and staff experience, policies and procedures
  • maintaining good working relationships with NHS England and the Care Quality Commission local teams and to bring a primary care view into the wider picture of quality and patient safety
  • supporting and acting as a contact for the nurse workforce, including health care assistants, practice nurses and advanced nurse practitioners, to develop networks and support systems for the sharing of best practice, supporting registered nurses with revalidation and advise on training needs.
  • encouraging use of, and look for trends and patterns in, the National Reporting and Learning System and share learning from these
  • supporting all practice staff to strive for quality improvement.