The Practice Level Support (PLS) programme is a quality improvement initiative designed to provide pragmatic, hands-on support for practices using trained facilitators. When four GP practices in Mid and South Essex ICS needed facilitation support, experienced project management resource from Arden & GEM’s local IT service was deployed.
As a result of clear objectives, flexible facilitation and forming strong collaborative working relationships with the PLS team, the ICB and practices, the programme was successfully delivered. A number of changes have been implemented to improve patient engagement and operational efficiency, ensuring a better overall experience for both patients and staff.
The challenge
The level and complexity of demand in general practice is increasing and practices are facing a widening gap between this demand and the capacity available to meet patient need. This is one of the challenges tackled by the Modern General Practice model, along with improving the workforce environment for staff and improving patient experience.
The PLS programme is a quality improvement initiative designed to support practices to move towards the Modern General Practice model. Pragmatic, hands-on support is delivered directly to practices by trained facilitators. Over 1,000 practices have taken part in programme so far, enabling them to plan and deliver improvements in productivity, patient outcomes and staff wellbeing.
Arden & GEM is working collaboratively with Midlands and Lancashire, North of England, and South, Central and West Commissioning Support Units as one of five PLS Delivery Partners.
When four GP practices in Mid and South Essex ICS – participating in the PLS programme for 2025-26 – needed facilitation support, experienced project management resource from the local IT service was deployed.
Our approach
To quickly understand more about the programme and their roles as facilitators, the three Project Managers undertook extensive training and attended various group sessions. Learning topics were broad and included quality improvement methodology, care navigation and capturing data to evidence impact.
Engaging with practices
With background knowledge in place, facilitators then began engaging with their assigned practices. Introductory meetings took place with the respective Practice Managers via Microsoft Teams. These were used as an opportunity to get to know the Practice Managers and their practices, provide assurance about the facilitation role and outline the support that could be provided to navigate the programme.
A key part of the introductory meetings was scheduling in a further 12 on-site visits (taking place weekly). The weekly sessions enabled facilitators to complete their responsibilities in supporting the practice.
Identifying and implementing changes
The first four on-site visits were diagnostic sessions to determine how to help the practices make maximum progress across one or more areas. This process included:
- Capturing baseline data and current position
- Completing practice journey maps
- Collating improvement ideas from the wider team including representatives from patient engagement, business management, administration, total triage, secretarial as well as clinicians to ensure a whole practice approach.
Facilitators provided an independent viewpoint with a solid understanding of change management to help practices work through ideas – questioning and probing where appropriate – and consider what implementation might look like.
"The facilitator was friendly and helpful. We went through the initial questions which were useful to get me thinking about how we can improve our service."
Greenwood and Wyncroft Surgery
The remaining eight sessions supported the practices to implement change. An action plan was created for each practice to inform weekly sessions and enable planned and achieved actions to be tracked. This tool has also helped keep practices pragmatic about what can realistically be accomplished.
Celebrating and sharing success
The support concluded with a celebration and learning event hosted by the PLS team. Other local practices were invited to listen and learn as part of the group based learning session.
The outcomes
The four practices have identified, and are now implementing, various changes to enhance operations and positively impact patient and staff experience.
While change initiatives have ranged in scale and scope, from restructuring teams to updating website content, they will all play a part in streamlining processes and ensuring better communication.
Changes include:
- Merging Administration and Secretarial teams to enable shared learning and build resilience
- Establishing a dedicated Patient Experience Office to improve patient communication and data collection, and enhance confidentiality
- Creating a steroid clinic
- Putting in place a new Standard Operating Procedure for total triage
- Assigning ‘app champions’ to be available in the waiting area to assist patients in using the online consultation tool
- Developing a skills matrix to capture the skill mix of practice staff
- Giving staff clear information on response timeframes e.g. for prescription requests and appointment bookings, and encouraging them to clearly relay this to patients
- Ensuring all Reception team members are available to answer calls between 8-9am
- Placing sample bottles, and clear signage, at the front of the reception desk, to reduce the need for patients to request them from staff.
The PLS programme has provided dedicated and facilitated time for practice teams to take a step back and proactively consider ways to improve service delivery. The tools and resources created will continue to be available to practices to maintain progress and inform evaluation.
"The facilitator has been very supportive and works collaboratively with our needs to see where improvements can be made, no judgement or taking over, just open discussions and works with our ideas to improve the practice processes."
Blandford Medical Centre
Find out more about our support for the PLS programme.