Collaborative improvement in Scottish GP clusters after the Quality and Outcomes Framework: a qualitative study.

Area of Science:

• Primary Care Policy
• Healthcare Management
• Quality Improvement Science

Background:

• Scotland replaced the Quality and Outcomes Framework (QOF) with a new GP contract in 2018.
• GP clusters were established to incentivize practices for regular quality improvement (QI) planning and organization.

Purpose of the Study:

• To investigate the organizational structure and perceived impact of GP clusters.
• To understand how GP clusters utilize quantitative data for improvement initiatives.

Main Methods:

• The study employed thematic analysis of semi-structured interviews with 17 stakeholders.
• Observations of 6 GP cluster meetings were conducted within two clusters.
• Purposive sampling ensured diverse stakeholder experiences and affiliations were captured.

Main Results:

• GP clusters exhibited varied administrative, data support, leadership experience, and QI skills.
• Collaborative learning focused on qualitative approaches, with less emphasis on data analytics due to access and quality barriers.
• Uncertainty existed regarding internal versus externally generated activities for clusters.

Conclusions:

• GP cluster development necessitates consistent training and support for leads in facilitation, leadership, and QI expertise.
• Enhanced access to and capacity for data analytics are vital for cluster effectiveness.
• Further investment is required to fully realize the potential impact of GP clusters.