1. Clinical Quality in OOH’s & Urgent Care Clinical Performance Management: 1.Collecting the data 2.Establishing the process to manage 3.Handling the clinicians

2. Handling the Clinicians Dr Simon Abrams Medical Director, Urgent Care 24

3. “Create an environment where good clinical care can flourish” Mike Farrar CEO, NW SHA

4. Professional status Why fight the tide?

5. Enable clinicians to do the jobs they are trained for and want to do.

6. Patient Journey Urgent Care 24 Delivery Communication DecisionsInterventions Outcomes

7. Enable clinicians to look provide good clinical care undisturbed by administrative and operational issues Working Equipment and consumables Working Computer and software Working Telephones Working Medicines Management Systems Admin/Ops staff: To fax prescriptions, Check phone numbers Make appointments Book ambulances Find Duty Social Workers To guide the service through the NQRs

8. Supportive Environment SOPS Operational Staff Fellow Clinicians On Call Directors

9. Workforce Plan Seek to recruit local clinicians Stringent recruitment process Induction process that sets standards

10. Setting Standards Service Level Agreement Clinical standards – RCGP Toolkit – Triage/DCA Standard Performance/Productivity Standards Make Expectation Explicit Work with Local Medical Committees

11. Educational Programmes Covers subjects relevant to OOH – Mental health – Palliative care – Medical emergencies – And other subjects Gives opportunities to discuss cases

12. Engaging GPs in the Governance of the Organisation Clinical Governance Committee Contributions to Audit Training GP Registrars Completing Adverse Clinical Incident forms Consultation Processes

13. Provide audit data that contributes to professional requirements of Appraisal and Revalidation

14. Telephone Triage Showing % Of Calls Completed Vs Mean Duration Of Telephone Consultations. (Each Diamond Represents One Associate) Urgent Care 24 “Super” Doc “Wrong Place” Doc “OK” Doc “Super-Duper” Doc

15. RCGP OOH Audit Toolkit 1 Elicits REASON for telephone call or visit 2 Identifies EMERGENCY or serious situations 3 Takes an appropriate HISTORY 4 Carries out appropriate ASSESSMENT 5 Draws appropriate CONCLUSIONS 6 Displays EMPOWERING behaviour 7 Makes appropriate MANAGEMENT 8 Demonstrates appropriate PRESCRIBING 9 Displays adequate SAFETY- NETTING 10 Develops RAPPORT 11 Makes appropriate use of IT / Protocols / Algorithms 12 Satisfies ACCESS criteria 13 CONNECTS with the patient/carer

16. Urgent Care 24

19. Anonymised Associate GP Performance Against the RCGP Toolkit Criteria