The debate about mortality rates at weekends is interesting and could run for ever. But this risks missing the key point - which is that one of the few remaining ways for the NHS to improve its productivity is to make full use of its investment in plant, expensive technology and equipment that frequently lies idle at weekend periods.
"Punitive over-regulation" - surely not. Try working overseas where regulation is generally much tighter...
All health and social care providers have to be able to meet the minimum standards that the CQC sets, why should GPs be exempt? And the evidence is that actually most practices score highly on their CQC ratings - and the ones that don't should surely be swiftly moved up to the standards of the rest. This is in the interests of the profession as a whole, and ensures that patient and public confidence is maintained.
My experience is that the majority of APMS contracts have been for practices that have struggled for some time previously to deliver high QOF and other performance parameters (or are totally new practices geared to high-need patients, areas of deprivation, etc) . It would be surprising therefore if they DID manage to perform to a par with more established practices. Spurious analysis here methinks?
You queried the definitions being used for the ratings of GP practices. There are some explicit definitions of what constitutes each of the 4 gradings being used by the CQC already published - see Appendix C of the GP Inspection Handbook published in early October 2014. See:
Hope this helps.
Richard Banyard (CQCassist)
PS Don't forget that the CQC have sought to mirror the OFSTED categories in their ratings system, which does of course now apply to ALL providers of health and social care in England.
Surely this can simply be resolved by phasing the net batch of CQC inspections towards the end of the period up to 2016 for those practices that have already been inspected (and where no substantive problems have been identified)?
Supply2Health no longer hosts AQP on-line bidding Portal?
Including a GP will be a helpful addition to a CQC inspection team, and will bring to play a wider dimension - but it is missing the whole point of the CQC to suggest that inspections are worthless without such clinical input. The CQC exists to ensure that a wide range of "minimum" standards are being met across the whole of health and social care. Such inspections already apply routinely for every other CQC registered organisation, in addition to GP Practices. And most of these criteria do not in fact need a highly paid and experienced professional to be present in order to assess them (as Professor Field indicates).
It would be more helpful to have professional views about the added-value that a GP can bring to the monitoring and inspection process - and how this can contribute to the huge challenge of levelling up standards across different practices so that all can emulate those of the best of UK primary care.
Some very useful information here. There are however a few slight inaccuracies:
i) If anew service is being provided, GPs DO need to apply (in advance) for approval from the CQC if this involves provision of an additional “registerable activity”. For example, unless a practice is already registered for providing Minor Surgery or Specialist Family Planning, then advance authorisation from the CQC will be required.
ii) Similarly, if the new service is to involve additional premises being used, then authorisation for this will also normally be required – in advance – from the CQC.
iii) Any new service being provided will necessitate the Practice’s CQC Statement of Purpose being updated, and a new version of the Statement published within 28 days of the new service commencing.
iv) Formal notifications to the CQC need to be made in the event of no fewer than 13 different circumstances – and a different form needs to be used for each one of these. (Copies are available on the CQC website). One of these notifications does involve any change in Partnership – but don’t forget that, in addition, formal applications will be needed to the CQC in this case, both to remove an existing Partner AND to add to new Partner. Partnership Agreements should not be signed until these CQC approvals have been granted.
v) During Inspections, the CQC may also wish to examine all the relevant paperwork about a GP’s authorisation to practice – including up-to-date copies of GMC registration, professional indemnity cover, qualifications, right-to-work, CRB/Disclosure and Barring Service clearance, mandatory training certificates, etc. This applies not only to GPs but ANY staff who have direct patient contact (including Practice Nurses, Health Care Assistants, etc).
The CQC regulations tend to be quite complex. Seek advice if there is any doubt.
"No one will inspect all 8500 GP Practices". I thought that the CQC had a statutory requirement to do this??
The CQC inspection regime is now gathering momentum. Inevitably this will reveal some interesting discrepancies across different practices in view of the historic patchwork approach to primary care provision across the country - different sizes, different capacity, different services, different types of premises, etc, etc. Watch this space.
Did the respondent complaining about going down to the Post Office mean "Disclosure and Barring Service checks"? (CRB checks disappeared last year).
Yes, applying to the CQC for a new registration can be quite complex and time-consuming - but there are low-cost specialist advice agencies for GP Practices out there who will make the process easy, quick and painless. Why not use them??
Response to Anonymous 01 April 9.53 am
A point well made – remember that it is the LEGAL ENTITY that is being inspected and registered (e.g. the Practice Partnership) by the CQC. The whole organisation is thus jointly and severely liable, and so everyone needs to be involved and as a minimum understand the issues, potential problem areas with compliance against the CQC standards, etc. This cannot just be left to the Registered Manager and/or Practice Manager.
Response to Anonymous | 01 April 2013 8:42pm
A wise comment – not least since the CQC are at present placing great emphasis on ensuring that its registered organisations are engaging their clients/patients. Indeed, the first of the 28 CQC standards is all about this! So make sure that you keep all the relevant evidence about this topic – such as the results of your patient surveys, minutes of your patient representative group meetings, details of suggestions made by patients and actions taken as a result, etc. Also, make sure that your material for patients (such as your Practice Leaflet) and your CQC Statement Of Purpose are all kept up-to-date since it is likely that the CQC inspector will ask to see these.
Richard Banyard, CQCassist
Good points, but no mention here of the extra pressures on all English practices also about to impact via the arrival of the CQC from April 1st . A range of extra forms will then need by law to be submitted to CQC within 28 days in the event of not-uncommon occurrences in practice (e.g. abuse/suspected abuse, incidents involving the police, unexpected patient deaths, short-term closures, changes to GP Partnerships, absence of the CQC Registered Manager, etc).