PrISMS Summit


PrISMS (Practices Improving the Safety of Medicines in Salford) is a Breakthrough Series (BTS) Collaborative designed to improve medication safety in primary care in Salford, commissioned by Salford Clinical Commissioning Group (CCG) and delivered jointly by the CCG and Haelo.

Eight Salford based GP practices have signed up to take part in this programme of work, with the aim that 95% of patients on high risk medicines (NSAIDS, Methotrexate and Amiodarone) will have optimised medicines care by October 2016.PRISMS Logo

The PrISMS Summit was held at the Innovation Forum on Wednesday 12th October. The afternoon session was a celebration of the programme, which began a year ago in September 2015.

The day began with Haelo’s expert faculty and General Practitioner Dr Neil Houston who welcomed and congratulated the teams on completing the year long programme.

Dr Tom Tasker, chair of Salford CCG, opened the Summit by praising GP practices for participating in this collaborative. Dr Tasker describes the wealth of quality improvement (QI) methodology knowledge that has been accumulated over the last year. He described how he personally has ‘enjoyed journey of learning’ and ‘as chair enjoy on a daily basis.’

Dr Tasker also commented that the programmes processes have assisted ‘proactive planning’ which has helped ‘reduce reactive’ work and that the PrISMS programme is ‘pivotal to the CCG ambition’ for Salford to become the safest health care economy in the UK.

After the opening remarks, Dr Neil Houston talked through the aims of the day; to reflect, to identify, to share and celebrate. Next up is our very own Programme Manager, Bridget Armour, who reflects that the “outcomes of this programme have been really great” and that the programme has “paved the way for future work between Haelo and the CCG.” Bridget introduces the first team presentation Mosslands Practice who run through their improvement journey.

Dr Neil Houston leads a reflective open session on ‘How did you effectively engage your team?’

Bridget Armour then continued to the relive the GP practice improvement journey discussing the Plan Do Study Act cycle (PDSA) which she recounts as ‘integral to QI and making changes in your practices’ showing the below clip of Learning Session 2 to demonstrate the rapid journey the teams have been on. Early process maps from the teams are shown and there is praise for the clarity that process mapping has offered the teams.

Safety Culture is next on the agenda which several teams described resistance in this aspect of their improvement journey. Dr Neil Houston sets out that this is a familiar obstacle and offered advice to the GP practices on how to overcome this issue. Neil believes that the process of introducing the tool of safety culture should be inclusive from the initial stages including the designing of the questionnaire, which should be anonymous asking questions such as what’s safety to you? Then with the results, discuss the way for improvement and be non judgemental in this respect you can ‘understand why and achieve buy in.’ Several GP practices describe how safety survey results have been ‘insightful’ on ‘how perceptions differ.’

Next up is Pendleton Medical Practice presentation, led by Dr Mark Austin and Practice Manager Susan Wilkinson who described their main challenge as time limitations due to increased workload; list size and appointment increase also resistance from some members of staff. The practice was offered advice from other practices to get clinician and manager buy-in from the start.

Dr Houston now leads table discussion on ‘What have you been the key successes in your practice?’. Teams commented that a key success was that the QI methodology ‘becomes part of your working day – normal practice’ and that the programme has aided ‘sustainable change’ and ‘imparted confidence.’

Alex Buckley, Data Analyst here at Haelo, then presented the ‘Good Stuff’ including measurement for improvement and data visualisation. Alex  talked the teams through the ‘amazing improvements we saw in the data’, what the teams had learnt and the interventions they had been testing. Alex also discussed the changes he had seen in the participants QI knowledge and capability before finishing with what the programme expected the practices to do next which included the implementation of the intervention bundle / change package collated by Haelo.

Kurt Bramfitt, Senior Improvement Advisor at Haelo, reinforces Alex’s sentiments that the teams now have started to understand the methodology and have ‘increased QI knowledge.’ Kurt stated ‘what you have achieved is fantastic!’  He implores practices to apply the intervention bundles to see greater change continue.

For the final round table discussions, Dr Neil Houston leads ‘What has been your key learning from being part of PrISMS?’


Conclusions include that ‘systems are not static’ and it is vital that the teams ‘carry on doing the measurement over time.’

Next up is Francine Thorpe, Director of Quality and Innovation at Salford CCG. Francine states that her key learning is that this programme has successfully ‘translated the Quality and Safety Strategy into practice.’ She praised the collaborative working with Haelo which has allowed for developed capability, improved efficiency and minimal variation. Francine describes the next steps as moving forward with the change package that has been developed from learning at PrISMS and Safer Salford, a programme of which one of the workstreams is Safer Medicines.

Certificates of programme completion were then given out to all eight practices. See all the team photos below. Dr Neil Houston then concluded the afternoon by highlighting the techniques that have allowed the teams to achieve so much in the past year; collaborate, refuel, share and learn. ‘Improvement is a journey!’

* 5 outcome measures have shown positive change.

* 3 outcome measures are running above overall target of 95%.

* All 8 practices have seen positive change in at least one measure.



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