Assessing quality and performance

Page last updated: 22 February 2024

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Example for a GP practice

To assess quality against a particular quality statement, operational colleagues specialising in GP practices will look at the required evidence categories. In this example, we are just looking at the infection prevention and control quality statement.

In general practice, the required categories for this are:

  • people’s experiences
  • feedback from staff and leaders
  • observation
  • processes

We would look at individual pieces of evidence under each category and based on the strength of what we find, give a score of 1 to 4.

For example, in the ‘people's experience’ evidence category, we may look at:

  • patient surveys
  • complaints and compliments

To gather evidence in the ‘feedback from staff and leaders’ and ‘observation’ categories, we might schedule:

  • an inspection to look at the care environment
  • a call to speak with staff at the GP practice.

We would then combine this new evidence with what we already hold on ‘processes’ to help us form a view of quality.

Example: combining evidence category scores to give a quality statement score

Evidence category Score Existing or updated score
People's experiences 3 updated
Feedback from staff and leaders 2 updated
Observation 3 updated
Processes 3 existing
Total score for the combined evidence categories 11  

We calculate this as a percentage so that we have more detailed information at evidence category and quality statement level, and can share this. In time, this will support benchmarking information.

To calculate the percentage, we divide the total (in this case 11) by the maximum possible score. This maximum score is the number of required evidence categories multiplied by the highest score for each category, which is 4. In this case, the maximum score is 16. Here, it gives a percentage score for the quality statement of 69% (this is 11 divided by 16).

We convert this back to a score so it is easier to:

  • understand
  • combine with other quality statement scores to calculate the related key question score.

We use these thresholds to convert percentages to scores:

  • 25 to 38% = 1
  • 39 to 62% = 2
  • 63 to 87% = 3
  • over 87% = 4

In this case, the percentage score of 69% converts to a score of 3.

We then use this score to give us an updated view of quality at key question level. In this case it is for the safe key question:

Example: combining quality statement scores to give a key question rating

Quality statement Score Existing or updated score
Learning culture 2 existing
Safe systems, pathways and transitions 3 existing
Safeguarding 3 existing
Involving people to manage risks 2 existing
Safe environments 3 existing
Infection prevention and control 3 updated
Safe and effective staffing 2 existing
Medicines optimisation 3 existing
Total score for the safe key question 21  

Again, we calculate a percentage score. We divide the total (in this case 21) by the maximum possible score. For the safe key question, this is 8 quality statements multiplied by the highest score for each statement, which is 4. So the maximum score is 32. Here, it gives a percentage score for the key question of 65.6% (this is 21 divided by 32).

At key question level we translate this percentage into a rating rather than a score, using these thresholds:

  • 25 to 38% = inadequate
  • 39 to 62% = requires improvement
  • 63 to 87% = good
  • over 87% = outstanding

Therefore, the rating for the safe key question in this case is good.