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

Outputs:

• 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