Dilemma: Publishing your CQC rating
You expect to be given a poor CQC rating, but are obliged to publish it in October. You worry it will put new patients off joining the practice. How can you handle this?
Dr Jim Sherifi: Be honest with patients
While an unfavourable CQC inspection report might at first appear to be an indictment of a practice it can also be viewed as an endorsement of all that is good albeit with an invitation to be even better.
The positives should be accentuated and the negatives both acknowledged and addressed. This message needs to be transmitted by the practice to its patients and this can be done through patient participation groups, the practice website and the practice newsletter (highly recommended if you do not already have one).
Patients should be directed to the CQC website where they can view the full report. It is better to facilitate this rather than appearing to be hiding something by letting them come across it by chance or malevolent means.
The CQC prides itself on being open and transparent and the practice should show that it is no less so. Remember too that the CQC is primarily safeguarding the public in ensuring that high standards prevail through primary care.
Again we should show that we not only subscribe to this ethos but are also pro-active in having the highest self-imposed standards. As such, despite reflexive misgivings, we should accept the CQC findings and be up front in explaining how we are going to address them.
Dr Jim Sherifi is a GP in Sudbury, Suffolk.
Dr Richard Stokell: Produce a balanced report
The aim of publishing the results at this stage is to ensure that poor CQC ratings in specific areas are viewed against the overall performance of the practice and also the practice demonstrates a willingness to accept outside criticism in a positive way and develop effective plans to improve these areas.
The first step is to discuss the report with the practice manager and partners as soon as possible so that a draft plan about how to present the findings and possible action plans can be quickly be shared with all the staff and the patients group. The ideas of these groups can then be used to improve the information published and produce action plans that are sufficiently robust to satisfy both CQC and our patients. It is important at this stage to reassure staff and be sensitive to their feelings.
To produce a balanced report, I would introduce the role of CQC and its importance in raising standards in primary care. I would emphasize the successes of the practice in recent years, provide recent data such as patient satisfaction and quality and outcome information. I would also provide details of all the areas inspected by CQC, giving details of those found to be satisfactory but also giving specific details of the negative findings. Details of how the practice plans to improve these areas and the timescales would closely mirror the information required by CQC.
Dr Richard Stokell is a GP in Birkenhead and associate director of the Mersey Deanery.
Vickie Priests: Focus on areas in which you performed well
We won’t have a ‘poor’ rating as such. A service that isn’t seen to be doing very well after inspection will either be judged to ‘requires improvement’ or be ‘inadequate’ – but also could mean inadequate under one of the domains, for example.
The purpose of our inspection reports and our rating is to encourage services to improve. A poor rating, whilst not being easy to respond to, should be viewed as an opportunity to improve the quality of care you provide to your patients.
Look at the inspection report in detail. We will describe what needs to improve and will make recommendations for improvement.
Spend some dedicated time planning how to address the issues we have raised. Involve all staff in this discussion and consider how to involve patients. Speak with your Area Team and CCG to see what support they can provide.
Look to other local practices, which may have had better outcomes from inspections, for some ideas or advice on how to improve.
Prioritise your improvement activity. If there are a number of issues we have identified it might be difficult to address all at the same time. Some issues we have raised may be more serious because they are putting patients at risk, or because we have identified a breach of regulations.
Don’t forget to acknowledge where you are good. Our inspection reports will identify good or outstanding practice as well as bad.
Vickie Priest is a policy manager for GP practice inspection at the CQC.