1. Bernadette Cornor, CORNERSTONE® simplification project
Simplifying quality
Bernadette Cornor, CORNERSTONE® simplification project

2. What’s it all about?
The way general practice operates has changed significantly since CORNERSTONE® was created – it’s no longer fit-for-purpose
Practices are dissatisfied with it, describing the programme as “repetitive, expensive and stressful”
Some have called it a millstone rather than a cornerstone

3. What do we want to achieve?
A simplified quality programme for general practice
A foundation or core standard as the quality assurance standard for all general practices in New Zealand
An advanced standard that could comprise foundation requirements, quality improvement and a suite of modules for certain services, eg: teaching registrars

4. How are we doing this? Quickly!
We’re conducting 4 design cycles and consultation phases to develop and test ideas with GPs, practices and stakeholders
The draft proposal to simplify the College’s quality programme goes to the College Board on 5 December 2018
New standard and programme implemented from 1 April 2019

5. What do GPs and practices want?
After the first design cycle, we asked GPs and practices to give us feedback on three choices to provide direction for more detailed design
The results?
Foundation Standard should include legislation, regulation, patient safety and equity (60:40)
High support for retiring the Annual Programme (70:30)
Modules for CORNERSTONE® are popular (80:20)
Too close to call regarding introducing credit values for CORNERSTONE® modules (48:52)

6. What about the Foundation Standard?
All poll respondents unanimously support a minimum quality standard for general practice
One-third would prefer it contained only compliance with minimum legislation and regulation
Two-thirds prefer it contained compliance with minimum legislation, regulation, patient safety and regulation
A few suggested it be made up of modules too

7. The beginnings of a framework
FOUNDATION/CORE STANDARD
(MANDATORY FOR ALL PRACTICES)
REGULATION
LEGISLATION
PATIENT SAFETY
EQUITY

8. The beginnings of a framework
ADVANCED STANDARD
PRE-REQUISITE
CORE/
FOUNDATION
ADD-ON MODULES
TEACHING
CLINICS
MINOR SURGERY
etc
MANDATORY
QUALITY IMPROVEMENT

9. What do you think?
What is “minimum legislation and regulation” for general practice?
Compliance that is unique to general practice, eg: practising certificates, authorised vaccinators OR
General practice-specific compliance and other relevant compliance, eg: disabled access, electrical safety

10. What do you think?
Should Foundation Standard and CORNERSTONE® be uncoupled from each other?
If yes, what would the effect be on your organisations?

11. Thank you