A qualitative evaluation of a Clinical Effectiveness Scheme in London

Background Clinical Effectiveness Southwark (CES) is a London-based primary care Quality Improvement (QI) scheme with the aim of improving clinical quality across local general practice. In order to improve patient outcomes in selected long-term conditions, a team of four GPs, working with other professionals, developed condition-based short guides, clinical templates, and other educational interventions.

Aim A mixed methods evaluation of the processes and impact of CES in its implementation and operation phases.

Method In the first year, qualitative methods were used which included 18 interviews, one focus group and observation of 53 meetings, educational events and teleconferences. The data were analysed thematically using NVivo software. The result of surveys with local clinicians about their use of CES guides are reported.

Results In the first year since formation, CES produced seven clinical guides and three templates. Six months after the launch of the first three guides, 57% of the survey responders reported using at least one guide in their practice. Electronic templates took longer than expected to develop. The existence of other (typically online) guidelines and a wish for even shorter, more concise, guides were among the reasons reported by those who did not use the guides on a regular basis.

Conclusion There is a demand from GPs and nurses for high quality, well-written, short, easy to use, local guides for various conditions.