Monthly column for providers and professionals working in primary medical and dental services from Professor Steve Field, chief inspector of general practice.

A busy June saw two publications look back on the improvement story of 10 GP practices and also on the state of urgent primary care in England.

GP improvement

Earlier in June we published the latest in our series of Driving improvement publications. Through 10 case studies based on interviews with staff from the practices and also those who helped within the local support network we share the stories behind the improvement journeys of the individual practices.

At the heart of their progress was an understanding that everyone at the practice had a role to play — including clinical, nursing, administrative, managerial staff and patients — and the importance of recognising what each person could contribute to the improvement journey. This commitment to multidisciplinary working was a key theme across all the case studies.

We also know that professional isolation is a common root cause for a practice receiving a poor rating. What these practices did was tap into the networks available to them, with many citing support from the Royal College of General Practitioners, the clinical commissioning group and NHS England as invaluable.

Through working with others locally, accepting the support available nationally and empowering practice managers, the practices that generously contributed to this report all demonstrated an impressive commitment to not only driving high-quality care for their own patients, but also helping others to learn from their experience.

More than anything, these stories show that improvements can be made despite the pressures in the system and is testament to the hard work carried out every day by practice teams across England. I hope you find the time to read through the case studies.

State of care in urgent primary care

This month we also published The state of care in urgent primary care services. Our analysis shows that the majority of walk-in and urgent care centres, NHS 111 and GP out-of-hours services in England are rated good or outstanding. However, a small number of services remain rated as requires improvement or inadequate.

Our first inspections in 2014 saw considerable variation in quality across providers. Through re-inspection though we have seen improvement and services delivering outstanding care by embracing new and innovative ways of working, working jointly with other services in the urgent care system and showing some outstanding leadership.

We know that well-resourced and integrated urgent care not only provides safe, high quality care to people, but can also ease pressure on other areas of the NHS — particularly emergency departments during the winter period and other times of peak demand. These benefits should not be overlooked.

That is not to say that we aren’t aware of the challenges that the sector as a whole faces. We know many providers experience pressures relating to staffing, a fact compounded by the reality of unsocial working hours and high reliance on self-employed clinicians. These issues presented themselves on our inspections of these services but also following engagement with our Expert Advisory Group made up of key stakeholders, as well as through discussions with the voluntary and community sector.

It is encouraging that the majority of care is rated good or outstanding and important that commissioners and other services recognise the value that urgent care offers as part of integrated care for people in a local area. As CQC’s interim work reviewing local systems has shown, the relationship and interaction between services is vital to better patient experience and outcomes. I have been heavily involved with much of this work and I will be sharing more thoughts from our final report next month.

Have a great month everyone.

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