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Clinical Effectiveness Group

UCLP Proactive Care Frameworks

Update: CEG is collaborating with UCL Partners on their Proactive Care Frameworks. The programme will help primary care practices deliver proactive care to patients with long-term conditions post-Covid, where as much as possible needs to be delivered remotely. 


Blue graphic showing heart and lungs

The frameworks include search and stratification tools built by CEG for EMIS and SystmOne. They stratify patients into high, medium or low risk, or priority cohorts based on clinical and other criteria. This allows practices to prioritise which patients need to be reviewed early and who can safely be phased for later review.

The search tools are accompanied by extensive resources, including:

  • Pathways that maximise use of remote care and the wider workforce, including pharmacists and HCAs/link workers.
  • Scripts and protocols to help staff deliver support for patient education, self-management and lifestyle change.
  • Training, including motivational interview and health coaching techniques.

These resources are all free and can be accessed via the UCL Partners website.



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