North Cumbria 2005

The North Cumbria PRIMIS+ service was set up in 1999*. Since the introduction of the new GMS contract (nGMS) in 2004, the team had been working hard to support practices and the PCTs with their data requirements, while still keeping the emphasis on quality data. The team's first task was to update the templates that practices were already using for the recording of data for asthma, diabetes, heart disease, hypertension, heart failure and stroke, ensuring that the templates included the required minimum data set. The team also set up new templates for the remaining clinical areas to meet data recording standards for nGMS.

The next task was to collect baseline data from all practices, comparing their current achievement against their aspirations for all clinical indicators. The PRIMIS+ team provided individual reports to each practice and a comparative report to the practices and PCTs.

Practices were then invited to submit achievement data quarterly. Despite the additional work involved in terms of extracting data from the population manager or clinical audit programmes, practices have clearly seen the benefit of this, with 70%-98% of them submitting data each quarter. These reports allowed practices and their PRIMIS+ facilitators to identify data quality issues and make improvements at an early stage, with monitoring throughout the year.

In April 2004, the PRIMIS+ team worked with practices to look at the prevalence and apparent prevalence rates for all the nGMS clinical areas. The existing PRIMIS+ data quality queries were used for this purpose, and similar ones developed for the remaining nGMS clinical areas, with support from local GPs. Individual practice feedback reports were subsequently produced to assist feedback, along with a set of local queries to identify the names of the patients to target for register improvement work. This support has allowed the team to provide practices with a tool to help them to tidy up their disease registers, as well as providing the PCT with their first ever local prevalence data. This will be repeated in 2005.

Finally, the PRIMIS+ team has been supporting the PCTs and their practices with their data requirements for Enhanced Services. Having worked with the PCTs to determine the data required to monitor both levels of activity and payments, the team has developed templates for recording the appropriate data for each Enhanced Service area. This has been supplemented with a programme of quarterly MIQUEST queries, which are fed back to practices, providing a collated report to the PCTs and support for the practices to improve data recording and address data quality issues. Recognising the need for good quality data, the PCTs encouraged the practices to spend the first two quarters of the period working on their data quality, before starting to use the feedback for monitoring and adjusting payments based on the data.

Although somewhat depleted by maternity leave and secondment opportunities, Carol's team has provided this nGMS support in addition to core PRIMIS+ data quality work and other local initiatives. These have included supporting District Nurses and Health Visitors in the use of practice clinical systems, general paperlight working, and numerous data extractions for local and national audit purposes.

* Since this case study was first produced, North Cumbria PCT was amalgamated into Cumbria PCT, following the 2006 PCT restructuring.