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Peer Review

Peer Review Background, Principles and Steps

What is Peer Review?

Peer Review provides an opportunity for groups of dentists to get together to review aspects of practice.  Groups are comprised of between four to eight dentists and there must be at least two different practices involved.  The project can consist of two or three meetings, with a variety of different topics being considered.  The meetings should take place with the practices of those involved in the group.

The aim is to share experiences and identify areas in which changes can be made with the objective of improving the quality of care/service offered to patients.  It is for dentists to take the initiative in contacting other dentists in other practices to form a Peer Review group.

It is important that each participating dentist is willing to have some aspect of his/her own practise reviewed.

One dentist should act as the Lead Dentists for the project and will take on the responsibility for submitting the project for approval, coordinating the meeting and completing and submitting the final Peer Review report.

In preparing a proposal for a Peer Review project, dentists should bear the following points in mind:

(a) It must be well structured and include clearly defined goals;

(b) It must have substance, but should not be too ambitious.  It is better to concentrate on a few topics in some depth, rather than have a superficial look at a wide range of topics;

(c) There must be some potential benefit for GDS or PDS patients;

(d) It must not be purely research or a form of traditional CPD.  A clear distinction must be made between Peer Review and other educational programmes.  A Peer Review project may highlight the need for dentists to pursue some educational activity in a particular area, but the educational activity, itself, cannot be part of the Peer Review;

(e) A Peer Review project must not consist solely of meetings at which a guest speaker gives a talk on a particular matter, although a presentation by a guest speaker might be part of a group discussion on the subject;

(f) It should not consist of dentists meeting to prepare for a postgraduate degree or diploma examination and be used as a vehicle to fund such meetings.


Principles of Peer Review as a form of Clinical Audit Activity

The Scottish Government Health and Social Care Directorate Clinical Audit and Peer Review working group have agreed the following principles for the initial introduction of Peer Review as a form of verified Clinical Audit Activity.  These will be reviewed during the first year of operation and any changes implemented prior to the start of the next three year audit cycle in August 2016.

  • Peer Review groups will comprise a minimum of 4 dentists and a maximum of 8 dentists, with at least 2 separate practices involved.
  • There will be a minimum of 2 and a maximum of 3 meetings within each Peer Review project.
  • There will be a maximum of 7.5 hours available – 7.5 for the Lead Dentist and 6 hours for all other participants.
  • If two meetings are planned, they should amount to around 5 hours with 0.5 hours for preparation per meeting.
  • If three meetings are planned, they should amount to around 4.5 hours with 0.5 hours for preparation per meeting.
  • The 1.5 hours of additional time for the Lead Dentist is to cover the organisation of the project, coordination of the meetings and submission of the final Peer Review report.
  • The Lead Dentist will confirm the hours undertaken by each dentist as part of the final report.
  • Guidance will be adapted from the existing NES guidance for Clinical Audit and SEA and will be available on the NES website and within the NES Portal.
  • All forms and reports will be fully electronic and online within the NES Portal with no paper submission possible.

Step 1: Agree the Peer Review group members

If you are considering setting up a Peer Review group, you will need to secure the involvement of between four and eight colleagues, at least one of whom must be from another practice.  You should also check that they all have current NES Portal accounts, so that you will be able to add them to the project at the application stage.

Step 2: Agree the topic or topics that the group will discuss

This stage involves the selection of a topic or topics to be discussed.  These can be clinical or non-clinical and may have resulted from a significant event or some other activity within your practice that you feel could be improved.  Significant Event Analysis (SEA) or Clinical Audit can be a useful initiator for identification of appropriate topics.

Do not be tempted to include too many topics within one project.

You should select Peer Review topics where:

  • Clear national standards and guidelines exist e.g. SDCEP guidance problems have been encountered in practice;
  • There is a clear potential for improving patient care;
  • There are areas of high volume, high risk or high cost, where improvements can be made for the benefit of the practices.

Examples of a clinical Peer Review project and a non-clinical Peer Review project can be found here.

Step 3: Agree the standards to be used

http://www.scottishdental.org is an excellent site with links to a large number of standards documents e.g. SDCEP and SIGN guidance.

Make a list of the source material you will be using as a basis for your discussions. 

Step 4: Agree the process that will be followed

This will include discussion with the group members about practical issues such as the locations to meet, the times and duration of the meetings, agreeing who will write up the notes at each meeting etc.  You should also agree the dates of the meetings in advance to ensure that all members will be able to attend. 

Step 5: Submit your Peer Review project for approval

Dentists wishing to submit a Peer Review project should first ensure that all members of the group are registered with the NES Portal as it is only through Portal that projects can be submitted. If you have not already registered with Portal, go to www.portal.scot.nhs.uk to access the home page and follow the instructions for creating a new account.

Once registered, the Dental Audit section can be located with the iBooklet section and from here you can use the New Application tool, to complete the equivalent of the old GP216A (rev 4/11) in order to apply for approval of your project.

The following points should be noted in relation to project submission:

  1. All projects must be approved before commencement.
  2. All dentists taking part in the Peer Review project must be added as participants by using the Project Participants tab.  Only dentists with Portal accounts can be added.  Once you have searched and added them, you can amend the hours requested for each participant to reflect their involvement in the project.  You      should do this before you submit the project for review and approval.  The Lead Dentist can select up to 7.5 hours, and the other participants can be set at a maximum of 6 hours.
  3. The application must be submitted via Portal and is sent electronically to a NES audit administrator, who will in turn allocate it to a NES reviewer for consideration.
  4. The maximum duration of all projects is six months from the approval date and the final report must be uploaded by the end date.
  5. The hours approved initially are based on an anticipated standard of final report and these may be altered if the submitted report varies from this expectation.

Note – After the initial automatic acknowledgement of receipt, projects will be reviewed and we aim to approve or seek amendments within 4 weeks of submission, though it will often be much sooner than this.

Step 6: Undertake the Peer Review Project

Once you have received approval for your project, you should meet and discuss the topics outlined in your application.  You should make a note of anyone who doesn’t attend any of the meetings and it is recommended that a brief report of each meeting is written, immediately afterwards.  The final report template can be used as the project proceeds for this purpose if you wish.

Step 7: Produce and submit your final Peer Review report

This report should contain the information required to demonstrate to NES that the Peer Review project has been carried out in line with what was proposed and approved.  It should include a brief report of each meeting, an overall summary and a list of the hours undertaken by each participant, certified by the Lead Dentist.

The overall summary of the project should highlight the main issues that have been covered, what has been learned and what further work is needed including any outstanding education or training needs.

The report must be received within six months of when the project was approved. Any reports received after this cannot be processed and the approval will lapse and the project status will be updated to ‘incomplete’.

All reports and associated paperwork must be uploaded against the project in Portal using the Final Reports tab.  This only becomes available after the project is submitted and approved.  There is no need to upload anything until the project has been completed.  Please store all documents locally until they have been filled in and are ready to be uploaded and submitted.

Once your final report is reviewed and your project is certified, you will receive an email advising you of this and giving you the link to download a GP217 (rev 04/11) to which you should attach your certification, which states the number of hours of clinical audit activity undertaken and therefore the number of hours of clinical audit allowance which GDPs are eligible to claim.  At present, this must be sent in hard copy to PSD, but we hope that electronic claiming will be possible in the future.