.svg)
Personalised Care Adjustment (PCA)
What does Personalised Care Adjustment (PCA) mean?
Examples of how to use the golf term Albatross
- Only apply PCAs when clearly justified and after making multiple attempts to engage patients
- Document all PCA decisions thoroughly with clear clinical reasoning
- Review PCA rates regularly to identify potential patterns of over-exclusion
- Maintain a register of patients with PCAs to ensure they receive appropriate alternative care
- Use PCAs as an opportunity to personalise care plans rather than simply excluding patients from services
Examples of how to use the golf term Albatross
- The GP applied a Personalised Care Adjustment to the patient's record after they declined the recommended medication despite counselling on its benefits.
- Primary Care Networks are required to monitor their Personalised Care Adjustment rates to ensure they're being applied appropriately and equitably.
- The practice nurse discussed the possibility of a Personalised Care Adjustment with the patient who was unable to attend regular health checks due to mobility issues.
What does Personalised Care Adjustment (PCA) mean?
A Personalised Care Adjustment (PCA) is a mechanism within the NHS Quality and Outcomes Framework that allows GPs to exclude specific patients from certain quality indicators when clinically appropriate. Previously known as 'exception reporting', PCAs recognise that standardised care isn't always suitable for every patient due to individual circumstances, preferences, or when treatments would be clinically inappropriate.
When would a GP use a Personalised Care Adjustment?
GPs may apply a PCA when patients have declined recommended interventions despite being offered information about benefits; when patients don't respond to multiple invitations for reviews or treatments; when treatments are contraindicated or inappropriate for specific patients; when patients have joined the practice recently and haven't had time for interventions; or when patients are receiving palliative care where quality indicators might not be appropriate.
How do Personalised Care Adjustments affect patient care?
PCAs aim to improve patient care by recognising individual circumstances while maintaining quality standards. They ensure that patients aren't subjected to inappropriate interventions while protecting practices from financial penalties for factors outside their control. PCAs should prompt personalised alternative care plans rather than simply excluding patients from services. When used properly, they support truly patient-centred care that respects individual choices and clinical situations.
What's the difference between a Personalised Care Adjustment and exception reporting?
Personalised Care Adjustment replaced the term 'exception reporting' in 2019 as part of NHS England's efforts to emphasise personalised care. While the practical mechanisms remain similar, the terminological shift reflects a more positive, patient-centred approach. The change acknowledges that excluding patients from certain indicators isn't about 'exceptions' but about tailoring care to individual needs, preferences, and clinical circumstances.
How are Personalised Care Adjustments monitored in Primary Care Networks?
PCNs monitor PCA rates through regular audits and reviews to ensure they're being applied appropriately and consistently. High PCA rates might indicate issues with patient engagement, clinical processes, or inappropriate application. PCNs are expected to analyse patterns in PCAs, compare rates between practices, identify opportunities for service improvement, and ensure excluded patients receive alternative appropriate care. This monitoring helps maintain the integrity of quality frameworks while supporting personalised care.
Hire a remote pharmacist
by December 14
