Accessibility | A | A | A

 

News and press office

WAM CCG Governing Board - 3 April

Windsor Ascot and Maidenhead Clinical Commissioning Group (WAM CCG) Governing Body Meeting Wednesday 3rd April 2013, 2-5 pm

27/03/2013

North and West Reading CCG Board Meeting

North and West Reading CCG warmly invites you to meet their new Board members, listen to discussion of the agenda and ask questions.

22/03/2013

NHS Berkshire East Research

NHS Berkshire East is working with Verve Communications looking at how people use and understand their local services.

28/02/2013

View all news items | RSS Feed

Shaping the Future

Chief Executive's Blog

About our GP Services

 

Quarter Two - 2012-13 Practice Profiles

NHS Berkshire East Practices

NHS Berkshire West Practices

 

NHS Berkshire: Commitment to Improving GP Services

Each day thousands of patient appointments take place in GP Practices. In any one year nine out of ten people in the UK will see their GP. Primary Care acts both as a first point of contact and as a gateway to other services.

There are many examples of outstanding GP care in Berkshire thanks to investment in services and the dedication and commitment of GPs and their staff. NHS Berkshire is committed to working with GP Practices to ensure that this high level of service is available to all.

GPs are self-employed professionals who have a contract with NHS Berkshire to provide Primary Medical Services to patients registered at their Practice. NHS Berkshire is held to account for ensuring this investment continues to deliver high standards of primary care.

Practice Profiles
NHS Berkshire produces quarterly GP Practice Profiles .These bring together data from a variety of sources in relation to each of the GP Practices in the local area. Practices are assessed against a range of key measures and are scored 3 (high achievement), 2 (meeting expected achievement levels) or 1 (below expected achievement) for each of these. The Profiles enable NHS Berkshire and Practices to reach an objective and rounded view of performance. They encourage self assessment and peer review and enable us to recogniseand celebrate success. They also enable us to objectively identify where performance could be improved and to work together on these areas.

NHS Berkshire was formed in 2011. It is a cluster arrangement between the Berkshire East and Berkshire West Primary Care Trusts. Practice Profiles haven been produced in Berkshire West since 2009. Other tools were used in Berkshire East. From August 2012 a combined Practice Profile has been produced for all practices in Berkshire. There are however some indicators for which data is only available for either East or West practices and these are noted below.

Supporting Patient Choice

NHS Berkshire aims to offer choice to patients within the framework of services it commissions. As part of our commitment to enable patients to make informed choices, and following consultation with the public and GP Practices, data from Practice Profiles is now published on this website. The data currently published on this site is a subset of the full Profile.

Further information

Please note that for more general information about opening hours, staff and services provided or to post comments about your experiences of a Practice, you should visit NHS Choices. This is a national website providing information about healthcare services. Practices may also have their own website please see NHS Choices or ask the Practice for more details. The NHS Choices website also provides further information on all of the conditions referred to here.

Patient Voice
Prior to publishing this data for the first time, NHS Berkshire consulted with the local population to seek their views about the data to be published.

The responses from this consultation have been invaluable to NHS Berkshire West in understanding what information patients might find useful and have contributed to the content and format of this website.

Indicator Explanations
The data published is based on the following list of profile indicators. Further explanations about what these indicators mean are given below:

Quality and Outcomes Framework (QOF) points achieved

The Quality & Outcomes Framework (QOF) is a national system to remunerate general practices for providing good quality care to their patients, and to encourage further improvement of the quality of health care delivered. The QOF criteria are grouped into 4 domains: clinical, organisational, patient experience and additional services with points relating to each area. In total, there are a possible 1000 points and since the framework is incentivised GP Practices will receive payment according to their total QOF score.

The data presented here is from the 2011-12 QOF year. Practices that achieved 954 or more QOF points score 3, practices that achieved 950-954 points score 2 and the remainder score 1.

Has the practice completed the Information Governance Toolkit?

The Information Governance Toolkit is an online assessment which practices are required to complete annually. By answering the questions in the toolkit practices make a self-assessment of the standard of information governance within their practice. The tool is driven by Department of Health Information Governance policies and standards. It is possible to view completed assessments in full on the NHS Connecting for Health website.

Practices are scored on their achievement in the Practice Profile and a score of 3 means that the practice has completed the toolkit and achieved a score of satisfactory, a score of 2 shows that the practice has completed the toolkit and identified some areas for action and a score of 1 indicates that the practice has not yet completed the toolkit. These scores are updated quarterly.

(Please note that the process is a self-assessment and a score of 1 does not suggest that the PCT has any concerns about data quality or security, but rather this indicates that the practice has not completed the toolkit.)

What % of new patients were referred for investigation after a stroke?

Stroke, a loss of brain function due to a clot or bleed in the brain, is the third leading cause of death and the single largest cause of adult disability in England. The Department of Health have a campaign to inform the public about recognising the signs of a stroke and more information about ‘FAST’ – Face, Arm, Speech, Time to call 999, is available on the Stroke Association website at the link below:

http://www.stroke.org.uk/information/about_stroke/recognising_symptoms/index.html

Patients who have high blood pressure, diabetes and/or heart disease should work with their GP to try to manage their condition and this will help to reduce the risk of a stroke. GPs are encouraged to ensure that all patients with a suspected stroke should be assessed and investigated within seven days.

GPs’ work on this area is measured in the Quality and Outcomes Framework (QOF). This Profile indicator is based on QOF results. A score of 3 means 90% of patients have been referred for investigation within 7 days, a score of 2 means between 70-89% have been referred for investigation within 7 days and a score of 1 means less than 70% have been referred for investigation within 7 days. These scores are updated annually.

In a very small number of cases, practices may not have had any stroke patients and as such may score a 1 on this indicator for that reason.

When tested, what percentage of patients with a history of TIA or stroke had a blood pressure reading of 150/90 or less?

Stroke, a loss of brain function due to a clot or bleed in the brain, is the third leading cause of death and the single largest cause of adult disability in England. A transient ischaemic attack (TIA), or 'mini-stroke', is caused by a temporary fall in the blood supply to part of the brain, leading to a lack of oxygen to the brain. This can cause symptoms that are similar to a stroke although they don’t last as long. Stroke and TIAs are both medical emergencies requiring urgent treatment. Without treatment, there is a one in 10 chance that patients will have a full stroke within four weeks of having a TIA. With treatment, the risk of a further TIA or a full stroke can be greatly reduced.

Following a stroke or TIA, patients should have regular blood pressure readings. Blood pressure measures how strongly blood presses against the walls of your arteries (large blood vessels) as it is pumped around your body by your heart. It is measured in millimetres of mercury (mmHg) and it is recorded as two figures:

For example, if your GP says your blood pressure is "140 over 90" or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.

GP practices should work with patients who have had a stroke or TIA to control their blood pressure. Practices are therefore measured on the proportion of these patients whose blood pressure was 150/90 or less at their last reading through the Quality and Outcomes Framework (QOF). This Profile indicator is based on QOF results. A score of 1 means that this level of blood pressure has been recorded for 90% or more of stroke and TIA patients, a score of 2 means it has been recorded for 71-90% of these patients and a score of 1 means that it has been recorded in less than 71% of these patients. These scores are updated annually.

When tested, what percentage of patients with hypertension (high blood pressure) had a blood pressure reading of 150/90 or less?

A person is said to have hypertension when they have persistent raised blood pressure but no obvious underlying disease. GPs play an important role in working with patients with hypertension to identify whether there are any underlying causes and in advising patients about how they can change their lifestyle to reduce risk factors. Good communication between patients and their GPs can help reduce blood pressure and can help to decrease possible cardiovascular diseases, stroke and/or coronary heart disease. This is really important because vascular disease accounts for the largest number of deaths in people aged 65 and over in Berkshire West.

As GPs play such a vital role in managing the care of these groups of patients this work forms part of the Quality and Outcomes Framework (QOF). This Profile indicator is based on QOF results. A score of 3 means 80% or more of these patients have recorded blood pressure (B/P) of 150/90 or less, a score of 2 means between 70-80% of these patients have B/P150/90 or less and a score of 1 means less than 70% of patients have B/P150/90 or less. These scores are updated annually.

What percentage of patients with schizophrenia, bipolar affective disorder and other psychoses have a record of alcohol consumption?

GPs are expected to discuss alcohol consumption with patients who have these conditions and to record this discussion in the patient’s notes. This is because alcohol may affect the severity of the patient’s condition and the effectiveness of treatment. GPs’ work on this area is monitored through the Quality and Outcomes Framework (QOF). This Profile indicator is based on QOF results. A score of 3 means that this information has been recorded for 95% or more of these patients in the last 15 months, a score of 2 means it has been recorded for 90-95% and a score of 1 means it has been recorded for less than 90% of these patients. These scores are updated annually.

What percentage of patients with dementia have had their care reviewed?

GPs are expected to regularly review the care given to patients with dementia. This is reflected in the Quality and Outcomes Framework (QOF) which measure practices on the number of reviews completed in the previous 15 months. This Profile indicator is based on QOF results. A score of 3 means that reviews have been conducted for 90% or more of dementia patients, a score of 2 means that reviews have been conducted for 70-90% of dementia patients and a score of 1 means that a review has been conducted for less than 70% of patients. These scores are updated annually.

When last measured, what percentage of coronary heart disease patients had a total cholesterol level of 5 mmol/l or less?

Cholesterol is a fatty substance known as a lipid and is vital for the normal functioning of the body. It is mainly made by the liver but can also be found in some foods we eat. Having an excessively high level of lipids in your blood (hyperlipidaemia) can have an effect on your health and can increase your risk of heart disease and stroke. In people diagnosed with coronary heart disease, high cholesterol can increase the risk of further heart disease. People with heart disease should aim to get their cholesterol as low as possible.

GP practices should provide annual cholesterol checks to patients diagnosed with coronary heart disease and work with patients to reduce cholesterol where necessary. This is measured through the Quality and Outcomes Framework (QOF). This Profile indicator is based on QOF results. A score of 3 means that 85% or more of CHD patients had a cholesterol level of 5 mmo/l or less at their last test (which should have been in the preceding 15 months), a score of 2 means this level was recorded for 70-85% of CHD patients and a score of 1 means that it was recorded for less than 70% of CHD patients. These scores are updated annually.

How many patients with asthma aged between 14 and 19 have been asked if they smoke?

Starting smoking as a teenager increases the risk of persisting asthma. There is also evidence that if a patient stops smoking their asthma may become less severe and easier to control.

Under the Quality and Outcomes Framework (QOF), GPs are expected to discuss smoking with asthma patients aged 14 and 19 and to record this discussion in the patient’s notes. This Profile indicator is based on QOF results. A score of 3 means that this information has been recorded for 90% or more of these patients, a score of 2 means that it has been recorded for 80-90% and a score of 1 means that it has been recorded for less than 80%. These scores are updated annually.

When tested, what proportion of patients with diabetes had an HbA1C of 8 or less?

If you have type 2 diabetes, your GP or diabetes care team will need to monitor your blood glucose levels. The HBA1C test gives an accurate guide to the ‘average’ level of sugar control over a couple of months. It is a different test to blood glucose that simply measures the sugar at that particular time. Studies show that patients with low levels of HbA1C (below 8) have significantly less complications from diabetes such as renal failure and blindness.

GPs and their staff have an important role to play in working with patients to agree and maintain a target HbA1C level. This work forms part of the Quality and Outcomes Framework (QOF) and this Profile indicator is based on QOF results. Practices scoring a 3 have achieved an HbA1C result of 8 or less in 78% or more diabetic patients. A score of 2 means this level has been reached in 70-78% of diabetic patients and a score of 1 means that this level has been reached in less than 70% of diabetic patients. These scores are updated annually.

What percentage of patients with diabetes have had a micro-albuminuria test?

Microalbumin tests are used to identify kidney disease that can occur as a complication of diabetes. If kidney disease is diagnosed early enough in people with diabetes, more effective treatment can be used. GPs should offer this urine test to diabetic patients annually. This work forms part of the Quality and Outcomes Framework (QOF). This indicator is based on QOF results. Practices scoring a 3 have a test recorded for 94% or more of patients with diabetes. Practices scoring a 2 have a test recorded for 90-94% of diabetic patients. Practices scoring a 1 have a test recorded for less than 90% of diabetic patients. These scores are updated annually.

Percentage of patients on the Gold Standards Framework with a full care plan in place

(Data currently reported for practices in the West of Berkshire only)

The Gold Standards Framework (GSF) is a programme of care for patients with advanced disease from which they are not expected to recover. GSF involves the primary care team working together with patients, carers and with other professionals involved in care. The aim is to improve the organisation and quality of care for everyone in the last years of life whatever their age or illness.

GPs and the district nursing team identify patients who they believe may be in the last year of their life. These patients are then being placed on a palliative care register. Their condition is continually assessed and their care planned. Planning a patient's care is the key. It's done in consultation with the patient - the aim is to ask a patient what kind of care they would like and where they would like to receive it. These preferences are then recorded and passed on to other medical professionals including out of hours doctors who don't know the patient personally. By co-ordinating, assessing and planning a patient's care in this way doctors and nurses can avoid admitting a patient to hospital when it is not essential and can enable the patient to be cared for and to die in their chosen place wherever possible.

Practices that have chosen to participate in the Framework carry out an audit each year which checks how many patients who have been on the palliative care register over the previous year have had a full care plan agreed between the patient, their carers and the professionals involved in their care. This indicator is based on the results of this audit. Practices scoring a 3 have had full care plans in place for 95% or more of the patients on their register. Practices scoring a 2 have had a full care plan in place for 90-95% of patients. Practices scoring a 1 have had a full care plan for less than 90% of patients. These scores are updated annually. Some practices scoring a 1 are not formally using the Framework but will be co-ordinating care for palliative care patients in other ways. Likewise, practices in the East of Berkshire have other arrangements in place for managing the care of palliative care patients.

National Patient Survey results

The National Patient Survey seeks to find out public opinion of GP services by asking a selection of patients to answer questions about their experience of their Practice. Patients are asked to rate their Practice on a variety of areas such as opening times, accessibility, availability of services etc. Here, 4 key sections have been selected. Currently scores are updated annually.

(A) Percentage of patients satisfied with telephone access
As core of 3 shows 75% or more of patients who answered the questionnaire were satisfied, a score of 2 shows between 65% and 75% were satisfied and a score of 1 shows less than 65% were satisfied.
(B) Percentage of patients reporting that they have received enough support from local services and organisations to manage their long-term condition.
A score of 3 shows 65% or more of patients who answered the questionnaire were satisfied, a score of 2 shows between 60 and 65% were satisfied and a score of 1 shows less than 60% were satisfied.
(C) Percentage of patients reporting overall experience of GP surgery as good.
A score of 3 shows 90% or more of patients who answered the questionnaire were satisfied, a score of 2 shows between 85% and 90% were satisfied and a score of 1 shows less than 85% were satisfied.
(D) Percentage of patients reporting overall experience of making an appointment as good.
A score of 3 shows 80% or more of patients who answered the questionnaire were satisfied, a score of 2 shows between 75% and 80% were satisfied and a score of 1 shows less than75% were satisfied.

How many extended hours appointments were used?

We are committed to building on the work already done to secure better access to GP services so that patients can see their GPs at times that are convenient to them. NHS Berkshire is encouraging Practices to open earlier in the morning or later in the evening on weekdays and at weekends. These times are called extended hours. Practices have to demonstrate that they extended hours they have chosen are at times that patients wish to go to the surgery. As part of this they have to tell the PCT how many of their extended hours appointments have been used. A score of 3 on this indicator shows that more than 70% of appointments have been used. A score of 1 shows that less than 70% were used. There is no score of 2. Scores are updated quarterly.

If you would like more specific information about Practice extended hours please go to NHS Choices.

What percentage of possible Enhanced Services does the Practice provide?

All Practices are required under their contracts to deliver a core range of services. In addition NHS Berkshire encourages Practices to provide enhanced services such as influenza immunisations and chlamydia screening. This indicator measures the proportion of the enhanced services available which the Practice has signed up to offer. It is important to note that providing these services is not a contractual requirement and there may be valid reasons why the Practice is not choosing to provide these services, e.g. capacity of staff. Not all services are appropriate to all Practices.

A score of 3 means a Practice is providing 95% or more of the enhanced services it could choose to offer. A score of 2 means that 85-95% of appropriate services are provided and a score of 1 means that the Practice is providing less than 85% of the enhanced services it could do.

Does the Practice provide comprehensive information on NHS Choices or have its own website?

NHS Berkshire looks to encourage all Practices to provide comprehensive information to patients. A score of 3 on this indicator means that a Practice either has its own website or has provided information on services provided, disabled access and Patient Participation Group arrangements on NHS Choices. Practices without a website or which do not provide this information on NHS Choices score a 1. There is no score of 2. Scores are updated quarterly.

What percentage of over 65s and younger patients in at risk groups have been vaccinated against flu?

Flu outbreaks often occur during the winter each year, which is why the illness is sometimes referred to as seasonal flu. Although flu can be unpleasant, if you are otherwise healthy, the illness will usually clear up on its own and you will recover within a week. However, the effects of flu can be more severe in certain groups, such as older people, pregnant women and people with an underlying health condition (particularly chronic heart or respiratory disease), or those with weakened immune systems. In 2010-11 there were 7,879 hospital admissions due to flu. Therefore, to protect against the potentially harmful effects of flu, it is recommended that these at-risk groups are vaccinated each year with the flu vaccine.

The first flu indicator assesses whether Practices have given 75% of patients over the age of 65 the seasonal flu vaccine. This score shows the percentage of eligible patients who have had this flu vaccine. A score of 3 shows at least 75% of Over 65s were vaccinated last year. A score of 2 shows that 70-75% of Over 65s were vaccinated and a score of 1 shows less than 70% were vaccinated.

The second flu indicator assesses what proportion of patients aged under 65s but in the groups described above were vaccinated last year. A score of 3 shows that 65% or more of these patients were vaccinated. A score of 2 shows that 60-65% were vaccinated. A score of 1 shows that less than 60% were vaccinated. These scores are updated annually.

Percentage of eligible patients who have had a smear test

NHS Berkshire looks at whether GP practices have conducted a cervical screening (smear) test for 80% of female patients aged between 25 and 50 every three years and for those aged over 50 every five years. This score shows the percentage of eligible female patients who have had this test, using year end data from 2011-12. A score of 3 shows at least 80% have been screened and a score of 1 shows less than 80% have been screened. There is no score of 2. Scores are updated annually.

Childhood immunisations

One of the most important things that a parent can do for their child is to make sure that they have all their routine childhood vaccinations. It's the most effective way of keeping them protected against infectious diseases. Further information on childhood vaccinations can be found at: Vaccines for kids - Vaccinations guide - NHS Choices

GP Practices in Berkshire offer vaccinations in accordance with the national programme. The Profiles measure how many patients have had three key routine set of vaccinations: the primary immunisations given by the time a child is 1, and the two doses of the MMR vaccination, given by the time a child is 2 and then by the time they are 5. A score of 3 on these indicators shows that a practice has vaccinated 95% or more of children due for these vaccinations. A score of 2 shows that 90-95% have been vaccinated and a score of 1 shows that less than 90% have been vaccinated. These scores are updated quarterly.

How many patients have been prescribed long-acting reversible contraception?

In order to support patient choice and reduce unplanned pregnancies, NHS Berkshire encourages Practices to offer patients a full range of options for contraception, including intrauterine devices (coils), implants and injections. Under this indicator, Practices are measured on their rate of prescribing such contraceptives compared to other Practices in Berkshire. Practices in the highest 40% score a 3, Practices in the lowest 40% score a 1 and the remainder score a 2. These scores are updated annually.

Has the practice recorded breastfeeding status at the mother and baby 6-8 week check?

(Data currently reported for practices in the West of Berkshire only)

The National Institute for Clinical Excellence (NICE) suggests that breastfeeding is associated with positive health outcomes for mother’s babies. The World Health Organisation reports that a lack of breastfeeding in the first six months of life can be a risk factor for infant and childhood morbidity and mortality. Further information about breastfeeding and the support networks available in NHS Berkshire can be found here. 

NHS Berkshire believes that GP practices, along with midwives and health visitors, have a role to play in promoting breastfeeding ante-and post-natally, including recording breastfeeding status at the 6-8 week check. The PCT is required to report on the number of mothers who breastfeed to the Department of Health and in order to do this, must first be able to demonstrate that it holds information about breastfeeding status for 95% of mothers. Practices are scored on the percentage of infants for whom breastfeeding status is recorded at the 6-8 week check in the Practice Profile. A score of 3 means that the practice has recorded the breastfeeding status of 95% or more mothers and babies, a score of 2 means between 93 – 95% have been recorded and a score of 1 means less than 93% have been recorded. These scores are updated quarterly.

Has the practice screened 15% of their 15-24 year olds for Chlamydia?

(Data currently reported for practices in the West of Berkshire only)

Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection (STI) in the United Kingdom and the number of diagnoses has risen steadily since the mid 1990’s. It is most common in sexually active young women aged 16 to 24 years and men aged 18 to 29 years. In the majority of cases there will be no symptoms and it can therefore be difficult to diagnose, yet untreated Chlamydia may have serious long-term consequences, especially in women. It can cause pelvic inflammatory disease (PID), ectopic pregnancy and even infertility. For further information about Chlamydia and access to screening services please visit your GP practice or find out more on NHS Choices.

Chlamydia screening helps to control Chlamydia through the early detection and Practices in the West of Berkshire are encouraged to screen their sexually active population in this age group. A score of 3 shows that the practice has successfully returned tests for 10% or more of its practice population of young people in the 15- 24 year age range, a score of 2 shows that a practice has successfully returned tests for between 5% and 10% of its practice population of young people in the 15- 24 year age range and a score of 1 shows that a practice has successfully returned tests for less than 5% of its practice population of young people in the 15- 24 year age range. These scores are updated quarterly. The service is provided in a different way in Berkshire East.

Key