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Clinical Effectiveness Group

North East London: Supporting extraordinary improvement in a challenging region

Exceptional QOF performance

For people with hypertension, cardiovascular disease or diabetes, North East London has had the best control of blood pressure and serum cholesterol in the UK. But this hasn’t been easy. The three inner east London boroughs of Tower Hamlets, Newham and Hackney are among the most disadvantaged and socially diverse in the UK. In these areas, rates of ill health are among the highest in Western Europe.

Our data-driven tools have helped to propel those boroughs from the lowest quintile of performance in 2008 to the very top national ranking in the Quality and Outcomes Framework (QOF) by 2018; nationally ranking first, second or third in 25% of 60 clinical indicators. The outer London boroughs we have supported since 2018 have also made substantial improvement.

 

During Covid-19, performance across the country has suffered. East London has been very badly affected by the pandemic. Nevertheless, North East London has maintained a high ranking in QOF, performing best in London in 2020-21 for key diabetes and lung disease metrics and a close second for key cardiovascular metrics.

How did they do it?

North East London Clinical Commissioning Group (CCG) commissions CEG's support, giving its practices access to tools and training that help GP teams work smarter. Our digital templates and referral forms make it easier to input the right codes into the patient record at the point of care and ensure no care processes are omitted. Our searches and call/recall tools use those codes to search, filter and prioritise patients, helping clinicians meet their targets and deliver services more equitably. Staff have the support of CEG's primary care facilitators and support officers who conduct practice visits, hold webinars, send regular e-bulletins, and provide guidance and training on effective use of our resources.

The region's practices also benefit from CEG-led academic research and quality improvement programmes supported by research grants. With our primary care support team working with GP teams on the ground, these have resulted in extraordinary improvements in particular areas, for example in reducing strokesmanaging chronic kidney disease, and most recently addressing falling rates of childhood immunisations

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