ACE Foundation

This is the minimum standard in primary care we expect from our GP member practices and focuses on:

  • Engagement and involvement – Encouraging practices to get together on a regular basis to share information, provide peer support, inform the wider work of the CCG and keep abreast of developments within the organisation.
  • Medicines management – Over previous years, medicines management interventions have delivered significant improvements in the quality of prescribing within primary care and this will continue to be promoted.
  • Quality and safety – Promoting an increased emphasis on improving quality and safety of services for patients. This will be achieved by encouraging practices to continue using the GP Feedback Tool, provide a mechanism for practices to report case studies from significant events so they can share learning, and improve the quality of GP referrals.
  • Carers – Playing a key role in identifying carers, offering them basic information and advice, signposting or referring them for more specialised support and providing locally sensitive services.
  • Prevention – Proactively managing patients to improve health outcomes. This will be achieved using evidence-based interventions which can help ensure patients' long term conditions are identified early on and receive the most appropriate management at an early stage of their condition. This will include three aspects:

- Atrial Fibrillation Screening – This is a common and serious condition affecting at least 1.8% of the population, rising to over 6% in people aged over 65. People with AF are five times more likely to have a stroke and have an increased risk of premature death. Through the ACE Foundation level programme patients over 65 who have no previous diagnosis of AF will be offered screening.

- Prescription 4 Exercise (P4E) – The leading causes of morbidity and mortality are high blood pressure (13% of total deaths), tobacco use (9%), high blood glucose (6%), physical inactivity (6%) and obesity (5%). Although physical inactivity is an independent risk factor it influences most other causes, including obesity. Exercise levels in the West Midlands are the worst in England – through the ACE Foundation level practices will be incentivised to promote physical activity using the P4E tool.

- Immunisations and vaccinations – Birmingham currently performs significantly worse than the England average on the majority of vaccination target indicators. This aspect of the scheme will aim to improve GP practice uptake rates for the routine vaccine schedule and seasonal flu.

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