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Following onf from 4 years of formal testing of the Measurement and Monitoring of Safety Framework, AQuA has built a prominent position in terms of knowledge and excellence in the framework. 

One area that has been relatively unexplored in terms of the framework is the practical application in general practice. Given the importance the building of capability in general practice has in many Accountable Care Systems and System Transformation Plans, safety systems are a key part of this and could be an important element to these regional and national plans. Clinical Commissioning Groups are also beginning to think about how they can form a developmental rather than solely performance management relationship with their practices – safety is once such subject area that provides a neutral vehicle for forming this relationship around. 

Given the 8000+ practices in England alone, there is very little we can currently say to practices about the framework that is specific to their setting. AQuA are looking to set up a modest piece of work with local practices to learn what it takes to apply the framework and what the practical application might look like. 

We will use the  Seddon problem solving framework of Work (within general practice) which is shaped by the System (within and external to) which in turn is shaped by the Thinking at the top of the system. This programme will follow the learning to bring out lessons and discussion points for engagement moving forwards. We plan to end the programme with a really engaging workshop with system members which will present them with the system influence on safety, and working with them to unpack the thinking that drives the current system design


  • Learning and detail around the practical application of the framework specific to general practice (primary care). 
  • Detail around what it takes for general practice to build a safety system.
  • Learning around what it takes for general practice to do this – IE what in the current general practice system contributes to, or hinders work around safety.
  • System leaders workshop connecting Primary care with system wide leaders to surface whether perceived problems are genuine or based in myth.
  • Whole system learning and improvement with practical examples  
  • Set of blog or discussion pieces for AQuA and Q newsletters. 

What might it take:

  • Creation of a case for change for general practice. IE summary of what safety actually costs (recent cases etc). To give a foundation to interest practices in the subject. 
  • 8 workshop sessions with a general practice (perhaps with a group as they will have more infrastructure to support this).
  • Periodic expert input from author of the Measurement and Monitoring of Safety Framework

How you can contribute

  • Connections to primary care colleagues
  • Expert primary care clinicians to support development
  • Advice and ideas to support development


  1. Happy to support and be involved from primary care perspective.remember the interfaces of care unexplored area of safety as well.Liz Angier

  2. I think this would be a great project to do with Primary Care, some challenges around engagement I would think and 'selling' the idea to GPs to appreciate how it will make a difference to their practice though I think. Clear case studies would help here I feel with transferable themes or clear parallels for GP practice.

  3. It would be great to use this idea to both support and engage with Primary Care in quality improvement in the North West.

  4. Having used the framework successfully in acute and community settings it would be fantastic to share the learning and adapt it to primary care. This would be an excellent start to embed safety across all health and social settings as primary care is key to supporting patient safety.


  5. Guest

    Elizabeth Bradbury 2 years, 11 months ago

    I support this proposal as it will a) further test the M&MS framework and generate learning about how it can be applied in general practice that will be applicable across the UK; b) the Q network, wider AQuA membership and M&MS network provide ready-made routes through which to spread the learning; c) potentially improve the overall quality of care in general practice. The work is highly topical and is aligned to initiatives such as the Greater Manchester general practice excellence programme.

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