Skip to main content


How do cluster plans stack up against the following considerations in the planning of primary care services beginning with the letter “E” (in no particular order)?

  • Evidence—Are our plans informed by assessment of local population health needs, and evidence for best-buy interventions? See also CPSP sections 2a-c.
  • Effectiveness—Is the path we have chosen supported by delivery of intended outcomes, providing maximal benefits and minimum harms?
  • Expenditure—Can we cover/ control costs and have confidence in the sustainability of funding? See also CPSP section 3.
  • Efficiency—Balancing effectiveness and expenditure, are we providing value/ cost-effectiveness?
  • Ethics—Does our approach visibly respect the ethical principles of autonomy, beneficence, non-maleficence, and justice?
  • Emotion—What is our emotional intelligence telling us, given reason leads to conclusions, but passion leads to action? Advocacy rests on evidence; this contrasts with lobbying, which is often emotion-led, so sometimes we need a bit of both to effect change.
  • Equity—Are we ensuring access and other opportunities for service users is proportionate to need and outcomes?
  • Excellence—Are we delivering clinical excellence in conjunction with good service user experiences and patient safety i.e. the quality triad, per Darzi, or the six domains of quality—care that is safe, effective, patient-centred, timely, efficient and equitable, per the Quality and Safety Framework (WG; 2021)?
  • Engagement—Are we climbing the participation ladder, aiming for community empowerment? See also CPSP section 2a and See also ACD Toolkit section on communication and engagement.
  • Evaluation—Do we routinely scrutinise our interventions, programmes and services (ideally prospectively) to engineer quality improvements? See also CPSP section 4.