Bringing premises up to scratch
Assura property expert Andrew Darke on how you can prepare for CQC registration at your practice premises
Preparing your property for CQC compliance
The news that the Care Quality Commission (CQC) has delayed the deadline for GP registration will have been greeted with relief by many practices. Bringing older surgeries up to the required standard could become a costly and time-consuming exercise and we have already seen the costs associated with compliance cited as a reason for the potential closure of a small number of surgeries across the country. Converted premises are likely to be particularly problematic, and it is vital that GPs and practice managers take action now to be ready for April 2013.
There are two outcomes that have significant implications for property – outcome 8, which covers cleanliness and infections control, and outcome 10, which concerns the safety and suitability of the premises. The steps that are to be taken will vary from property to property, but for the vast majority there will be work to be done.
Designating a treatment room
For any treatment room, the changes that may need to be made will depend on the nature of the additional service that is to be provided. Counselling, for example, can be undertaken with very little need for alterations or refurbishment. However, once any minor invasive operation is carried out, whether by a GP or by a practice nurse, the room must comply with substantially more stringent rules and regulations. This could be as basic as the type of flooring, which should be seamless with an up-swept skirting to avoid leaving places where bacteria and dirt could lurk. Old-fashioned, converted houses with traditional skirting boards or even vinyl over plastic tiles will certainly be picked up by CQC inspectors. In certain circumstances, it may be necessary to look at any air-changing equipment to ensure the air is kept as clean as possible.
There are also a number of issues that could easily be missed by the untrained eye or those who are not completely up to date with the legislation. Many people might not be aware that the doors to a consulting room must meet with current decibel restrictions to protect patient confidentiality. Solving this problem might be as simple as adding door seals, but the challenge will be in spotting these shortfalls before the CQC inspectors come calling.
In the past, PCTs have had the financial ability to support practices in bringing premises up to standard when there has been a change of legislation, as was the case with the Disability and Equality Act 2010. In these straitened times, however, the NHS has very little capital available to assist GPs with the process. It may be necessary for Trusts and GPs to look to private sector landlords to help them meet new requirements.
One option to consider for GPs that own their own premises is a purchase and leaseback agreement, where property ownership – and thereby the responsibility for compliance – can be transferred to a third party as part of the leasing arrangements. This has a number of benefits beyond CQC compliance, removing many of the property-related headaches associated with incoming and outgoing partners and repair and maintenance issues. However funding is accessed, it is vital that it is put to use quickly to bring premises up to standard in advance of the deadline.
This is not only about ticking boxes – it is about ensuring the best possible quality of care for patients in the new healthcare environment.
Andrew Darke is the managing director of property at Assura Group Limited