Less pressure, more time for care – Brighton and Hove CCG, South East

Case study summary

Practice teams in Brighton and Hove are experiencing workload pressures.  Following a number of practice closures which required other teams to take on extra work, staff were struggling to keep up.  The CCG, which is made up of 37 practices, wanted to find ways to reduce some of the pressures its practices were experiencing and turned to the Productive General Practice (PGP) Quick Start programme for help.  The programme is part of the support available through the General Practice Forward View, and is delivered by the Sustainable Improvement team, NHS England.

The idea

Use PGP Quick Start to help practice teams to work more efficiently in order to reduce workload pressures.

Identifying the challenges

The challenges teams were experiencing varied between practices.  However, a number of themes were common.

  • In understaffed practices GPs were spending time carrying out administration tasks as there was no-one else to help. This meant GPs had less time to spend looking after patients.
  • Processes were inefficient and unnecessarily time consuming e.g. spending too much time on repeat prescription processes and not using tools that could improve efficiency such as the Electronic Prescription Service.
  • Team working needed improvement as in some teams job roles and responsibilities were not clearly set out.

The CCG initially rolled out the programme to seven practices.  Each practice was given the option to choose which areas of PGP Quick Start they wished to focus on.  This was followed by each team receiving onsite support from an experienced improvement facilitator who worked with them to develop and test new ways of working to make improvements using quality improvement tools and techniques.  The support helped staff develop new skills and confidence that would enable them to sustain and develop the changes they were making in the future.

Sharing and learning with other local practices

As part of the programme all practices were brought together in group based learning sessions.  The sessions gave teams the chance to learn from each other what was working well and any ideas they could adopt back in their own practice.  This was highly valuable as it encouraged practices to network, make connections and learn from each other.

Impact

The following shows examples of some of the impact that has already been achieved.

  • University of Sussex Health Centre which has five GPs and over 20,000 registered patients, redesigned a more efficient prescriptions process that released seven hours of GP time a week.
  • Pavilion Surgery has six GPs and over 10,000 patients. By using visual management techniques to ensure regular activities are completed on time, every time, they were able to:
  • release over 2 weeks of GP time and 5 weeks of administration time over the course of the year
  • vastly improved team working with administrators and receptionists feeling happier and more confident
  • patients are now able to access and secure appointments more easily, they can also request prescriptions online which is quicker.

Implementation tips

  • Have effective communications in place to help spread the word about the programme, targeted phone calls, emails and bulletins will help.
  • Encourage those who are participating in the programme to share their impact with others who are not currently involved. At one CCG meeting a GP and practice manager talked about their successes which was hugely powerful in encouraging other teams to participate in the programme.
  • Build a rapport with your programme facilitators, they are a valuable support and will be there to help if you come across any obstacles.

PGP Quick Start is the first programme we’ve come across that delivers onsite support for practice teams. It focuses on the issues teams want to tackle and gives them the support they need to make improvements.  Without a doubt it has opened up the door to make it easier for us to roll out other improvement programmes across our practices.”

Dr Katie Stead, Clinical Lead,  NHS Brighton and Hove CCG

If you would like to find out more about how you can access the Productive General Practice Quick Start programme, visit our ‘Releasing time for care’ web page.