The Royal College of General Practitioners (RCGP) quality improvement initiative using Clinical Practice Research Datalink (CPRD) data: Lessons learned

Helen Booth; Eleanor Yelland; David Mullett; Arlene Gallagher; Shivani Padmanabhan; Stephen Welburn; Janet Valentine; Puja Myles

doi:10.3399/bjgp19X703697

Abstract

Background Quality improvement (QI) is a priority for general practice, and GPs are expected to participate and provide evidence of QI activity. Pressures on the primary care workforce require approaches to QI to prioritise efficiency and effectiveness.

Aim This project aimed generate and scale up bespoke QI reports for GP practices contributing data to CPRD.

Method CPRD is a UK government research service facilitating public health research using anonymised primary care data. A pilot report was designed with stakeholders and covered two indicators from the RCGP Patient Safety Toolkit. The reports enabled GPs to identify patients needing case review and to benchmark data on practice-level prescribing. Reports for 12 practices, containing real patient data, were sent to GPs and feedback was obtained via interviews. The report was scaled up to 457 practices and a survey sent out to request feedback.

Results GPs used the reports to review the care of individual patients, and to implement QI actions such as adding flags to patients notes. One participant used the report as evidence for their annual appraisal. Survey response was limited (n = 31.7%) but overwhelmingly positive. Responders highlighted the importance of clinical input when developing indicators and ensuring the tone of the reports is supportive.

Conclusion The collaborative RCGP/CPRD QI reports are unique in their ability to provide benchmarking and case-finding on a national scale. The indicators selected must lead to actionable reports. Clinical input is required to ensure code lists are appropriate and that reports are clinically relevant. CPRD aims to send out two reports annually.

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The Royal College of General Practitioners (RCGP) quality improvement initiative using Clinical Practice Research Datalink (CPRD) data: Lessons learned

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