For over 20 years, a Clinical Effectiveness Group in East London has played a major role in improving health care delivery in three of the UK’s most deprived boroughs. Using a change model of ‘belief, act, motivate’, the group has helped the area become the UK’s highest performer over a wide range of GP quality indicators.

As a similarly deprived area of London, with a high disease burden and wide health inequalities, the Southwark Clinical Effectiveness Approach partnership will tap into some of the experiences of East London, in order to adapt and deliver a local model.

The model aims to make the right thing to do become the easy thing to do for busy clinicians, driving up quality, improving outcomes and reducing variation in general practice. 

The model is based on: ‘belief’ (guidelines, education and awareness-raising); ‘act’ (using trusted templates to support evidence-based practice, regular feedback through analytics and making understanding real-time data core to the daily work of clinicians); and ‘motivation’ (cross-practice learning and aligning incentives to clinical effectiveness areas).

The clinical effectiveness model will be delivered across 45 GP practices in Southwark, which together have more than 300,000 registered patients. 

The first wave of work involved clinical improvement initiatives in atrial fibrillation, type 2 diabetes and hypertension. The second wave covers breathlessness, asthma, chronic obstructive pulmonary disease (COPD) and heart failure. 

Primary care friendly guides have been produced for each of the conditions; and support is enhanced by the development of clinical templates and the delivery of education events and practice visits.  

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Scaling Up Improvement

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