What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

The primary care system is under severe strain. People do not always get the service they need, where and when they need it. Staff are under pressure to do more with the same or fewer resources and little time to change and improve.

Since 2018, Healthcare Improvement Scotland has developed and tested approaches and tools to support GP access. Our next step, in 2022, was the development of the Primary Care Access Programme (PCAP), which we have now tested with over 80 teams.

PCAP recognises the current context, whilst supporting teams to improve patient access. We focus on what can be achieved rapidly, using DCAQ and QI approaches and tools. After working with us, teams have knowledge and skills to apply these tools and approaches to other access challenges.

“We don’t need a massive amount of time to change systems.”
General Practitioner, 2022

“Learned about data collection for the first time.”
pharmacy support worker, 2022

What does your project aim to achieve?

Our objective is to further develop and spread this programme between 2023-2025 to empower local QI teams to use it to support primary care teams to improve access.

As a result, people using primary care services will be better able to access help from the most appropriate person, at the right time and in the right place.

Benefits for Local QI teams include access to:
– Tested resources
– Training and mentoring
– Network of PCAP facilitators

Benefits for Primary Care teams include:
– Expert local advice/support
– Insight into their demand, capacity and/or activity
– Changes which lead to improvements in access
– Opportunities to share learning widely
– More effective/efficient use of NHS resources
– Staff engagement, leading to a greater wellbeing and satisfaction
– Skills to apply to other/future access challenges.

We address inequalities by widening access for (not limited to):
– All ages
– Disability
– Gender related inequalities
– Marital status inequalities
– Race
– Socio-economic groups

How will the project be delivered?

Phase 1: We will use prior learning to develop and test a framework for PCAP. This framework will include all the information, tools and guidance that QI experts need to deliver PCAP with teams in their area. We will recruit QI teams to test the framework.

Phase 2: We will deliver a national collaborative, open to QI leaders who want to use this approach locally. Our experienced team will support participants to lead and implement the PCAP approach in their areas.

We will work with participants to evaluate delivery using measures including:
– Number of participating teams
– Number of teams reporting improvements in access
– Impact on capacity of QI/primary care teams

QI teams will work with local primary care teams to collect:
– Baseline demand, capacity, activity and, where possible, queue data
– Data on changes made
– Impacts achieved
– Evaluation data

We will support local teams to apply good governance principles including risk management.

How is your project going to share learning?

Each participating local area will share learning on:
– The number and location of teams they support
– The changes their teams make
– Impact of changes

This will be done via local, Healthcare Improvement Scotland and Q community events, distribution lists, websites, social media, networks/communities of practice, and other existing channels.

The framework will provide recommendations for sharing learning, including templates for our ‘Brief Insights’ visual case study format, a podcast outline and a heatmap template.