Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation

Abstract

BackgroundWhile practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK.

Narrative synthesis of health service accreditation literature

“…Overall, 65 studies examined the relationship between accreditation and different quality measures 6 21–23 25 26 29–31 36 37 39 42 44–46 51–80 83 84 88 90 95 96 101–103 105 106 109 118–125. Only 28 studies involved comparisons of accredited and non-accredited health services or health service units.…”

“…The impacts of accreditation on organisational processes, policies and environments were examined in 62 studies 3 6 21 23 25 26 28–33 36–39 41–44 46 49 51 53–57 59–61 63–66 71 73 75 81–99 106 111 112 122 126 127. As listed in table 4, several key subthemes were explored in these studies, including the extent to which accreditation programmes promote: standardisation of care processes; increased compliance with external programmes or guidelines (eg, clinical best-practice); development of organisational cultures conducive to quality and safety; implementation of continuous quality improvement activities; and superior leadership.…”

“…There were 38 studies that assessed health professionals’ attitudes towards accreditation using multiple methods 21 23 24 27 28 32–35 38 39 41 42 46 47 61 66 71 81 84 86 89 92 97 99 100 105 106 109 111 114–117 129–132. As illustrated in table 4, the literature highlights that health professionals view accreditation as an effective method of promoting high quality organisational processes and patient safety, and are more likely to remain satisfied and employed in accredited organisations.…”

“…Despite the increasing role of patients or consumers within contemporary healthcare systems, only 13 studies considered the relationship between accreditation and consumer views or patient satisfaction 6 27 46 84 88 104 106 114 118 122 123 136 137. The literature indicates that accreditation has an undefined impact on the views or satisfaction of consumers or patients.…”

Quality and Outcomes Framework: time to take stock

“…One such unifying concept for quality might be one of the practice accreditation schemes currently being piloted. 9 QOF was born in an era of plenty, but since the credit crunch in 2007, global recession in 2008, and tax rises planned for 2010, it is clear that we now need to adapt to an era of public sector austerity. It is timely therefore to consider the article by Fleetcroft et al 10 QOF has started to evolve into a value-for-money scheme.…”