Highly commended - Assuring Safety: A New Model for Monitoring Independent Providers (2025)

Leicester, Leicestershire and Rutland ICB

Project summary

We were asked to take over a newly introduced assurance process for independent healthcare providers (IHPs) across Leicester, Leicestershire and Rutland (LLR) on behalf of the Medicines Optimisation team. The aim was to ensure that IHPs were adhering to national and local NHS guidelines across a range of safety-critical areas: controlled drug (CD) prescribing, antimicrobial stewardship (AMR), formulary adherence, medicines safety incident reporting, PGD governance, and over-the-counter (OTC) guidance.

On review, we found the assurance process inconsistent, fragmented, and lacking structure. Providers were submitting vague internal reports with no standardisation, making it difficult to assess compliance or support quality improvement. Recognising the risks to patient safety and overprescribing, we redesigned the entire process.

Working collaboratively, we developed a Microsoft Teams-based digital form with targeted questions aligned to local and national standards. This streamlined data collection, reduced administrative burden on providers, and enabled clearer analysis. We also created standardised audit templates for each area, ensuring consistency and a level playing field across all IHPs.
We held an all-provider engagement session to explain the new process and gathered feedback, which led to further refinements. The new approach has increased provider engagement, enhanced the quality of assurance data received, and identified key safety risks — including CD prescribing errors and inadequate staff training at one provider. This allowed us to intervene early, highlight the concerns, and ensure actions were taken to mitigate risks.

The MS Teams form also revealed some providers mistakenly believed they did not need to report on controlled drugs, prompting targeted follow-up and education to ensure full compliance with reporting requirements.
Another notable outcome involved a provider offering cataract surgery who were using non-formulary eye drops without clearly informing patients or GPs. By working with the provider to update discharge letters, we helped reduce GP-patient conflict and improved continuity of care.

We promoted shared decision making throughout the assurance process and ensured patient information, both written and verbal, was available in multiple languages and accessible formats tailored to the diverse LLR population, enhancing patient understanding and engagement.
Our project has delivered clear improvements in patient safety, prescribing accuracy, and cross-sector communication. It also embedded green agenda considerations and supported the PSIRF approach through standardised incident reporting prompts.

This project is replicable, low-cost, and scalable, creating a reliable framework that could be used across other ICBs nationally to support assurance, reduce variation, and promote medicines optimisation.