I took the HKCFP exit examination in March 2009. As every candidate will know, it was a time of great stress and anxiety. It was hard work to balance all three segments of the examination; the consultation skills, practice assessment and audit. The practice assessment and audit were two segments of the examination that were new for me. I had never written an audit before and I was never previously involved in practice management. I am very pleased to say that I successfully passed the examination.

Shortly after my passing my Exit Examination, our clinic OT&P Medical Practice proudly received the Australian Council on Health Care Standard Certificate of Accreditation (ACHS); our clinic is now the first private practice in Hong Kong to receive this international accreditation. The exit examination and practice assessment gave me and our clinic so much more extra work. It was both time consuming and labour intensive; however the results were very rewarding. According to ACHS, “For consumers, accreditation is basically an issue of trust. People who use health care services want to have confidence that those services are safe and will provide consistent high quality care. People understand that there are risks associated with using the health system, but they want those risks minimized.”

The HKCFP exit examination had helped our clinic with some of the ACHS accreditation process. Going through the exit examination was a big help with some of the ACHS accreditation work. The exit examination experience resulted in a good understanding of the accreditation process and some of the work required for the examination was used in the preparation work for the ACHS accreditation. The emergency protocol written for the examination has been implemented as our clinic emergency protocol and was approved by the ACHS. Proper vaccine storage was a part of the practice assessment and protocol requirements were the same for the ACHS.

In many other areas of clinical practice, the ACHS and the exit examination requirements were similar. The audit written for the exit examination was also submitted to the ACHS and very positive feedback was given on the audit.

ACHS allows flexibility in which standards and goals are chosen and at OT&P we decided to implement the RACGP Standards from General Practice (as described in the RACGP book of that name). Of course it could also be said that had our clinic undertaken the ACHS accreditation process before my examination, my preparation would have been a little easier! However, the learning experience for me was very valuable.

OT&P has implemented an I SO accredited management and quality system since 2003. ACHS was chosen as a next step because it is more clinically relevant and ensures the highest standards at an international level.

The ACHS complies with all statutory and regulatory requirements. It involves continuous improvement. It looks at risk analysis and works to reduce risk in practice. It aims to achieve the best practice and thereby reduce indemnity and practice insurance. Clinics need to achieve at least moderate achievement in all areas that are assessed. ACHS is also one of three organizations recognized by ISQUA (The International Society for Quality in Health Care).

Areas that are assessed include: information management, human resources, practice management and clinical level assessment. All of which are similar to the HKCFP practice assessment package.

ISQUA lists a number of descriptors of accreditation. Accreditation:

• is a public recognition of achievement by a healthcare organization, of requirements of national healthcare standards, is generally available to public and private sectors
• covers a range of healthcare environments from local community-based care through tertiary level providers and healthcare systems
• is awarded based on achievement of quality standards and the independent external survey by peers of an organisation’s level of performance in relation to the standards.

The practice assessment part of the exit examination is so vital to high quality practice that I see it is a shame that it is only made available to exit examination candidates of the HKCFP. Perhaps a future direction would be to create a local practice accreditation system that would be available to all doctors in Hong Kong and not only exit examination candidates.

It could also be a continuous assessment process to ensure that good practice is maintained.