Table 2.

Context-Mechanism-Outcome configurations concerning access and engagement

Context	Mechanism	Outcome
General Practitioner monitoring individual patients	Focuses attention on medications	Attention focused on patients most in need of review
General Practitioner prescribing audited and monitored in practices	Proactively conducting own audits	Practice prescribing patterns benchmarked against each other across the Clinical Commissioning Group
Communication between Clinical Commissioning Group and General Practitioner	Real time feedback	Patients reviewed to ensure appropriate monitoring, to optimise medications, or to avoid dangerous combinations of drugs
Clinical Commissioning Group conducting searches of prescribing based upon “projects” and “initiatives”		Prescribing patterns and trends benchmarked against national targets and guidelines
Clinical Commissioning Group encouraging clinicians to be engaged in more proactive safety management	Engagement of practices in using the system for feedback Voluntary engagement by clinicians Audits conducted as a means of support to General Practitioners	The effectiveness of safety initiatives audited more quickly Improved engagement with safety monitoring of prescribing