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The waiting game

GP safety checks and error reporting among main areas of improvement, CQC reveals

The main areas that practices require improvement are in recruitment management and safety processes, including carrying out adequate pre-employment checks on staff and putting in place systems for reporting errors, the CQC has revealed.  

Writing in the British Journal of General Practice this month, the CQC’s chief inspector of general practice, Professor Steve Field, identified the most common areas where practices were failing during the regulator’s piloting phase of its new inspection regime, where it inspected 196 practices between April and September last year.

Professor Field said that ‘safety culture’ was one of the main areas where practices ‘required improvement’, including practices having no systems in place for reporting errors and no evidence of undertaking investigations into ‘significant events’. 

This comes after a recent Pulse analysis revealed that six of the seven GP practices to have been rated ‘inadequate’ under the new Ofsted-style CQC inspection regime had problems with GP recruitment - while the regulator recently placed the first three GP practices ever into ‘special measures’ since the start of the new inspection regime.

The BJGP’s article also added other safety culture issues requiring improvement included practices not having ‘adequate whistleblowing or safeguarding policies, or a poor understanding of them among staff.’

Meanwhile, the inspection pilots also found that the second most common area where improvement was needed were practices’ recruitment procedures - in particular pre-employment processes – with some practices not carrying out DBS checks on staff and poor processes in place for staff appraisals, the CQC said.

But the CQC also highlighted several of the main areas where practices were providing an ‘outstanding’ level of practice, including having effective multidisciplinary team working, accessibility to care, and meeting the clinical needs of the patient groups.

Writing in the BJGP, Professor Field said ‘It was common for inspectors to identify areas where a practice could improve its patient care or governance processes.

‘There was a median of three areas for improvement per practice, although this number varied considerably: 26 of the 196 practices had no identified areas of weakness; on the other hand, 16 practices were recommended to improve 10 or more areas.

He went on to add that the CQC is ‘powerful agent for improvement.’

Professor Field added: ‘By publishing ratings we encourage practices to improve, and by sharing examples of good practice and poor practice we help spread innovation and prevent common problems. However, we acknowledge that inspection can be a stressful time for practices.’

Readers' comments (3)

  • This is helpful for practices that haven't been visited yet, good to know what others have tripped up on.

    Completely agree with the comments on a safety culture - how many prescriptions were issued wrongly last month? What were the causes? How many unhelpful discharge letters were received by practices?

    Before other comments highlight the very real pressures on primary care, it's perhaps worth reflecting how useful answers to those questions might be to drive system wide improvement (not just in primary care).

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  • In reality the CQC wants an east german Stasi NHS where no-one wants to work any more except the bureaucrats. Anyone who actually tries to do any good will be regulated and monitored to a complete standstill. Dr Harold Shipman and Jimmy Saville would both have passed DBS. Harold Shipman would have got a good CQC report, as I suspect would the hospital where Jimmy Saville was "helping" - look at all that patient involvement.

    Yet another scandal will soon engulf the CQC, as some organisation that has just had a glowing CQC report will be unmasked to have been doing terrible harm and the CQC will be exposed yet again for the "we must do something" politicians' wet dream that it is.

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  • Give me 15m with every patient and a maximum of 25 in a day and you can have gold plated policy documents galore and I can have time to audit every little bit of my own practice every day. CQC and NHS managers have no idea of the stress involved in just seeing 40 + people a day let alone being able to reflect, audit and critique our work. NFI

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