ICBs told to mine new GP practice dataset for ‘unwarranted variation’

Exclusive NHS England has asked ICBs to use a new national dataset to compare GP practices in their area and ‘tackle unwarranted variation’ among them.

Local commissioners have been told to use the ‘GP dashboard’ as a tool to ‘improve access’ to general practice, according to documents shared by Cheshire and Merseyside ICB.

NHSE said in January that all ICBs are expected to put in place action plans by June to ‘improve contract oversight, commissioning and transformation for general practice’ and the new national data set will be used for this purpose.

According to the documents, the dashboard, which is expected to be live by next month, will include:  

• Number of general practice appointments per 10,000 weighted patients 
• Proportion of GP appointments within two weeks
• Percentage of patients describing their overall experience of their GP practice as ‘very good’ or ‘good’
• Percentage patients describing their overall experience of contacting their GP practice on this occasion as ‘very good’ or ‘good’
• Emergency ambulatory care sensitive (ACS) admissions per 1,000 registered patients
• All A&E attendance rates
• Cloud based telephony
• Percentage of calls to NHS 111 in hours
• Number of Pharmacy First common condition referral per 1,000 registered population

These indicators ‘are to be confirmed’ and are ‘under development currently’, the ICB document added.

The guidance said: ‘The GP dashboard will support ICBs in the implementation of their action plans (required by operational planning guidance) to improve contract oversight, commissioning and transformation for general practice, and tackling unwarranted variation.

‘ICBs should use the GP dashboard alongside local information, indicators and intelligence to identify unwarranted general practice service variation and inform their continuing risk-based approach to reviewing GP contracts, understanding practice needs and supporting improvement.

‘It should be noted that the expectation is that ICBs are working to a single list of variation indicators to target support and resources accordingly.’

It follows comments on variation in GP access made by health secretary Wes Streeting this year, who said some practices ‘not working as hard as they could’ and creating ‘unwarranted variation’ in GP services around the country.

The BMA raised concerns last year that NHS England could use cloud-based telephony data to ‘performance manage’ GP practices, after last year’s GP contract was amended to require practices to provide digital telephony data on eight metrics through a national data extraction, for use by NHS England, ICBs and PCNs.

At the time, NHS England said that the purpose of extracting this data ‘will be to better understand overall demand on general practice in advance of winter’ and its national director of primary care Dr Amanda Doyle said that there will be ‘absolutely no targets associated with it’ and ‘no financial implications for it’.

Pulse has contacted NHS England for comment.

Doctors’ Association UK GP spokesperson Dr Steve Taylor told Pulse that practices ‘need funding, support and help, not performance management’.

He said: ‘NHS England promised that call data would not be used for performance management of practices, despite warnings to the contrary that it might be by GPs.

‘GP practices will rightly be appalled that another area of practice work is being monitored. There are so many data points being measured that prove GP practices are the most productive area of the NHS.

‘Practices need funding, support and help, not performance management. Additionally ICBs have too little understanding of how GP practices work, with too little GP experience on their management teams.’