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How NHS data can help practices assess their performance

GPs may question the value of the huge amount data collected on their activities, but some of it is useful to practices.

Should GP practices be worried by all the data about them? (Image: iStock)
Should GP practices be worried by all the data about them? (Image: iStock)

Publishing data about GP practices is almost an obsession in the NHS and the amount of information in the public domain is growing all the time.

With just a few mouse clicks anyone can see such diverse information as how a practice’s care of its patients with asthma compares with others, how many of the surgeries’ patients attended A&E for psychiatric conditions last year and what patients think of the practice telephone system.

In England, these statistics are among 280 indicators on every GP practice that have been published by the NHS Information Centre in the six months from January to June 2012.

But do GPs need to worry about this plethora of information and can any of it be used to improve efficiency and performance? One strategy is to use the data to look at how the practice is performing in relation to others.

Comparing your performance
Dr Gavin Jamie, a GP in Swindon who also runs the QOF database website, says: ‘It is always useful to compare and to drill down into the data, for example on diabetes, and look at if there are any little changes that can be made.’

Luke Bennett, an Association of Independent Medical Specialist Accountants executive committee member and a partner at accountants Francis Clark, recommends such an approach on QOF.

‘If you dig a bit deeper and look at the prevalence for each disease you can consider, for example, whether your practice has a much lower number of patients with asthma than a neighbouring practice and what might be the reasons for that,’ he says.

Patients' views on practices
Practices are also being rated on patient perception, and this year the DH has added new statistics from the GP Patient Survey to every practice on the NHS Choices website.

Essex GP and NHS London Programme for IT's clinical lead for GPs Dr Phil Koczan believes practices can use this sort of data to improve service delivery. ‘It’s often quite tempting to ignore it as being irrelevant but it can be useful,’ he says.

‘For example we had patients complaining that they were spending a long time waiting on the phone not able to get through and so we have now installed a system which tells patients where they are in the queue and gives them an indication of how long they have to wait.’

NHS Alliance chairman and Devon GP Dr Michael Dixon argues that GPs need to gather their own data to improve performance as well as relying on national initiatives.

‘We have had just one comment on NHS Choices. I think it’s more useful to get properly articulated information from the local community.’

Understanding the context
Dr Richard Vautrey, deputy chairman of the GPC and a GP in Leeds, believes GPs are also right to be concerned that some of the data may mislead patients.

‘GPs can use information within their practices to compare with other practices because they understand the context with which the data needs to be qualified but I think it’s less helpful for many lay people,’ he says.

One way to tackle this is to ensure data is presented appropriately. Dr Koczan is involved in the myheathlondon project that provides patients in the capital with ratings on the city’s practices against a set of standards developed by NHS London with Londonwide LMCs.

Dr Koczan argues that strength of this site is information in context. So far 50% of practices have registered to add additional information - more practices than initially expected - and he suggests GPs do see the value of such sites.

Enhancing your profile
Mr Bennett says maintaining and enhancing the practice’s profile can be particularly important for GPs in areas where patients have plenty of choice of practices to register with. He advises practices to ensure all comments placed on sites such as NHS Choices are answered promptly, and that patients who have positive experiences of the surgery are encouraged to leave comments on the website as well.

He adds: ‘You can be judged on something as simplistic as opening hours. If there are three practices and one doesn’t open at lunchtime that might be a reason to choose one of the others.’ 

Too much information
However, Mr Bennett warns that one problem with some publicly available financial information – for example, on the NHS Information Centre site – is that it may be several months or more out-of-date. ‘A GP accountant should be able to provide you with more accurate and up-to-date figures that would be better to use for income comparisons.’

He says that information overload may be a further difficulty for practices considering how best to handle the data explosion. Dr Jamie points out that ‘an awful lot of angles’ are covered by current datasets including clinical quality, use of NHS resources and patient experience.

‘I think there is not a terribly clear idea of what we are actually after from all of this and I don’t think we have got clarity on what makes a good practice. For example, the NHS wants low referring practices but patients may like practices where they are more likely to get referred.’

While the NHS struggles to define that gold standard, the task for GPs at the moment is to sift out what is useful and await the next information innovation.

‘There are so many people out there that may have ideas but we don’t have the killer app for using that data yet,’ says Dr Jamie.

Public information that could help your practice

Practice information in the public domain includes:

  • How convenient it is to get an appointment.
  • Length of time spent waiting in reception
  • How good doctors are at explaining things
  • Average GP incomes by region.
  • Use of NHS resources such as number of referrals/A & attendances.
  • QOF performance.


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