Case study: Working in the NHS
Working in the National Health Service
Performance development structured and delivered in the genre of the industry

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Business Challenge
This is a composite case study as Echelon has been commissioned to develop a range of solutions for issues within the NHS – a sector with unique needs, pressures and constraints. These have ranged from improving patient and visitor care, to the development of continuous improvement tools in refining ‘lean’ practices, to the development and publishing of assessment procedures for GP practices (the solution in focus).
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Echelon’s Solution
Solutions are designed for implementation and delivery within the genre of the industry. Our customer service initiatives have been sustained by getting staff ownership through creating Best Ideas Clubs. Our lean publishing solutions have been developed for delivery in text and via the web to meet the varied needs of users, and our assessment tools are written in the language of the sector using live and representative case studies.
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Key Benefits
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In depth knowledge of the sector [our Head of Consulting has worked within or for the NHS throughout her business career – starting as a Graduate Recruit, moving on managing a leading Children’s Hospital, and now as the senior independent director for a Foundation Trust]
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Pragmatic solutions matching the constraints and capabilities of the profession
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Winner of National Communications Awards
Case Study: Working in the National Health Service
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Research
The solution in focus involved the publishing of an interactive Quality and Outcomes Framework Assessor Development programme for assessors of GP Practices. It enabled GP Practices to be assessed and evaluated for quality and for services covered. In essence it became a publishing project undertaken on behalf of the Modernisation Agency through its subsidiary NATPACT. Initial research involved checking out with focus groups existing material, how the material would be put to use and the challenges that assessors were likely to face.
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Buy in
Draft material, accessible both in text form and in html via the web, based on previous powerpoint presentations was converted into assessment activities and then taken back to these focus groups for piloting. Feedback was sought on the method of assessment content, and on the search and self-assessment functions. Previous reluctance to use the web was overcome once the benefit of these two functions was appreciated.
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Training
The Quality and Outcomes Framework (QOF) is a system to remunerate general practices for providing good quality care to their patients, and to help fund work to further improve the quality of health care delivered. It is a fundamental part of the new General Medical Services (GMS) Contract, introduced on 1st April 2004.
Working closely with the NATPACT team and other providers Echelon developed an extensive resource of learning materials for trainers to use in facilitated workshops and interactive modules for learners to use on their own. Source material was not available until mid June and launch of the NATPACT project launch on September 1.
Echelon was able to use its learning design and authoring skills to author new material and adapt material made available from NATPACT and then use its XML publishing and content management systems to design XML style sheet to enable material to be published in different formats including on the internet and CD-ROM. Housing the material on the content management system and using the XML publishing process means that material can be updated and republished quickly and easily and, where necessary, published in different formats.
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Communication
The NHS Improvements Agency working in conjunction with Echelon circulated material promoting the initiative and how it was going to be used. The initiative was then launched through a series of seminars to those who has elected to become assessors.
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Sustaining the initiative
A Help Facility was provided in the initial period of assessment so that assessors could check out frequently asked questions and request feedback in difficult situations.
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Evaluating the outcome
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Improved access to services by local people through Health and Social Services Boards commissioning enhanced services to encourage the development of a wider range of services closer to home.
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Fairer funding to remove historic anomalies in the current system where funding follows the GPs in post rather than the needs of patients and the local community;
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GPs able to manage their workloads by enabling them to opt out of providing some services, for example, out-of-hours;
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Better management of chronic diseases through a new framework which will provide significant rewards to practices to recognise improvements in clinical standards:
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Improved organisational standards by rewarding practices which provide better Improved organisational standards by rewarding practices which provide better records, more effective communication with patients and conduct patient surveys
Echelon, Angles House, 210 Sheen Lane, London SW14 8LB; 020 8274 9965



