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What is the challenge your project is going to address and how does it connect to your chosen theme?

We want to understand more about how older and unwell people are looked after in the healthcare system. Studies of unwarranted clinical variation often focus exclusively on hospital-based care. This project will identify opportunities for improvement by looking across the whole patient journey for people who frequently move between different healthcare settings.

We will focus on pneumonia, which results in 200,000 admissions to hospital each year in the UK and is a major cause of hospitalisation, particularly for older people and those in residential care. Our aim is to capture data on the critical role that GPs play in preventing, diagnosing and treating pneumonia in community settings, and in post-discharge support. Our challenge is to understand the impact interventions made in out-of-hospital settings have on both patient outcomes and hospital admissions.  This approach will benefit both healthcare providers and patients.

What does your project aim to achieve?

We want to better understand the current pathway of pneumonia care, particularly for older people and those in residential care, identifying examples of unwarranted clinical variation as opportunities for improvement. We will take a holistic approach, extending the use of clinical quality metrics from secondary into primary care and using patient history to explore potential opportunities to improve the early identification and treatment of pneumonia. The work is designed to generate insights that will inform the development of a number of quality measures designed to support primary care providers to improve pneumonia care and support better outcomes for patients.

How will the project be delivered?

Within the Advancing Quality (AQ) programme, we have a wealth of skills and experience in data analysis, QI methodologies and supporting organisations to improve the treatment of pneumonia in secondary care. We will use the same delivery approach in primary care, establishing a group of clinical experts to develop a set of targeted measures to support appropriate care. This measure set will enable peer comparison and promote the sharing of good practice.

We will work with Vision Health to access primary care data for pneumonia patients. Vision Health is a healthcare software provider with excellent coverage of the primary care sector. Their software also has analytical and reporting capacity. We will use a statistically significant sample of primary care data collected by Vision Health to create a joined-up picture of care for people with pneumonia, from diagnosis to discharge and beyond. We will share our findings using existing primary and secondary care collaborative networks.

What and how is your project going to share learning throughout?

AQ is an organisation founded on collaboration, whether this is through hosting showpiece networking events on clinical themes, webinars to enable discussion, or our daily work with trusts to promote better patient care. We will apply this ethos here, sharing key findings and involving partner organisations where possible to build new and strengthen existing improvement communities in the area of pneumonia. Through our established in-house communications team, we will promote our work and share content digitally to achieve the widest possible reach, using the network of contacts we have built up in over a decade of quality improvement experience in pneumonia and respiratory care.

How you can contribute

  • We’d welcome any comments on our proposal. If you are part of or are engaged with primary care networks, we’d like to hear from you to help us develop and share our ideas.

Plan timeline

14 Oct 2019 Begin to devise communications strategy for project
1 Nov 2019 Gather expressions of interest from practices in chosen area
15 Nov 2019 Confirm and visit practices participating in project
18 Nov 2019 Work with Vision to set up software on practice systems
31 Dec 2019 Complete set-up, training and governance arrangements
6 Jan 2020 Commence data gathering and analysis
29 Mar 2020 Devise reporting process for analytical outcomes
12 Apr 2020 Review outcomes
30 Apr 2020 Develop recommendations for improvements
14 May 2020 Share findings with participating organisations
29 May 2020 Share findings with teams at collaborative events
1 Jul 2020 Submit report to Health Foundation


  1. This is a great example of adopting a systems approach to already successful hospital focussed improvement work.

    This will have impact to share outside of your North West region - is this part of your project or will it be limited to the North West until you have learning to share?

    The strong evidence and clinical leadership that you have in place is impressive and will support the spread and engagement of future focus areas. Will you consider publishing the results to promote AQ and the project specifically?

    Good luck ladies!

  2. Potentially useful learning from this project. As part of the Patient Safety Collaboratives support with roll out of NEWS2 we have identified discrepancies in thresholds for escalation with CURB criteria vs NEWS2 so would be interested to hear how this is worked through. Will flag this project to those discussing this.

    Thanks Jo

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