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A Balanced Scorecard For General Practice

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A Balanced Scorecard For General Practice
A Balanced Scorecard for
General Practice
Andrew Ridley
Director of Primary and
Community Care Commissioning
Tower Hamlets PCT

Overview
• Why a BSC ?
• How was it developed ?
• What’s in it ?
• How is it being implemented ?
• Barriers and issues
• Improvements delivered as a result ?
• What next ?

Why a BSC ?
• A Focus on our role as Commissioner
• Variation in quality between practices
• Are the poor always poor , or the good

really always good ?
• Support a move from anecdote to transparent fact base
• Perception that current measures too vague
(eg nGMS) or not robust enough (eg QOF)

Why continued……
• Random cycle of measures; patient

survey, QOF, access survey, premises audit, clinical governance visits, prescribing audits, CEG audits.
• Rarely made public
• Concerns about profit levels
• To increase speed at which improvement is delivered

How ?
• Informal discussions re lack of

systematic assessment method
• Build a consensus for change –Medical
Director and PEC Chair critical in leading this • Early (1st) Draft shared with LMC before any corporate discussions
• 3 lengthy, and useful discussions with
LMC

How…continued….
• Process: DPCCC, Med Director, PEC

Chair wrote initial draft
• Informally shared with opinion formers
• Then LMC
• Revisions agreed
• Then PEC, Board and LMC again
• Then final LMC for sign off.

How……issues
• No objection in principle
• Concerns re workload; no relative

measures, absolutes preferred
• Absolute clarity around what is contractual and what isn’t sought; some debate about banding A,B, C
• Full LMC involvement sought – joint working group to manage implementation now agreed So….What’s in it………
• Contractual requirements
• HealthCare Commission standards and

therefore contribution towards PCT targets • Access – doctor numbers – controversial
• Patient survey measure
• BCP
• Results to be public and on PCT website

How is it being implemented
?
• Mainly by PCT Commissioning

Managers; Desk based assessment
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