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CQC inspection regime 'requires improvement', evaluation concludes

There is 'room for improvement' to the CQC's regulatory system, with GP practices among those least likely to improve as a result of the approach.

This is the finding of a major Government-funded evalutation of the CQC's latest inspection regime, that was launched from 2013 onwards.

In response the evaluation, carried out by researchers from the King's Fund and University of Manchester, concluded that CQC should adapt its regulatory approach to the type of health service provider it is dealing with.

The research, funded by the National Institute for Health Research (NIHR), pointed to qualitative evidence of 'providers... making improvements to organisational processes and to services' in anticipation of their CQC inspection. However, the report said there was 'significant differences in the way that impact works across... sectors'.

Citing the lack of opportunities for improvement for struggling GP practices, the report said the finding 'highlights the potential for CQC to develop its model in different ways in each sector'.

The report said: ‘Inspection and rating have dominated CQC’s regulatory model, consumed most of its available regulatory resources, and may have crowded out some other potential regulatory activities that might be more impactful.'

Other findings from the report included:

Ruth Robertson, report author and senior fellow at The King’s Fund said: ‘Although we heard general support for their new approach, we also uncovered frustrations with the process, some unintended consequences and clear room for improvement.’

‘We found that CQC’s approach works in different ways in different parts of the health and care system. When CQC identifies a problem in a large hospital there is a team of people who can help the organisation respond, but for a small GP surgery or care home the situation is very different.

'We recommend that CQC develops its approach in different ways in different parts of the health system with a focus on how it can have the biggest impact on quality.’

BMA GP Committee chair Dr Richard Vautrey said: ‘Proportionate and appropriate regulation can lead to good quality care for patients, and while the CQC is taking steps to improve the way it operates, this report highlights a number of issues with how inspections impact general practice.

‘It rightly notes that GP practices have less capacity to improve than other providers, often because of historic underfunding or support from their local CCG and previous PCT, but despite this, it is testament to the hard work of GPs and their teams that the vast majority are now rated good or outstanding – which is far higher than in any other major sector. Inspections can be disruptive for practices and their staff, and the associated workload takes GPs away from providing direct patient care.

‘It is therefore positive that this report recognises the flaws in this system and proposes that regulators’ efforts would be improved through the use of diverse strategies other than comprehensive inspection.'

CQC chair Ian Trenholm said it was 'good to see' the improvement work it is already undertaking 'explicitly recognised by the report'.

He added: 'Health and social care regulation makes a real and practical difference to people’s lives - there needs to be a strong, independent regulator who will always act on the side of people who use services. In an environment of pressure and change, we’ll continue to evolve our model to support the system to improve - and take action to protect people where necessary.

'We know our work is already leading to improved services and better care and there is strong support for what we are doing from the public and providers. With our next phase approach we are building on this work and moving forward, to ensure that more people get good care, more of the time.'

Readers' comments (13)

  • 😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂

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  • AlanAlmond

    Surely general practice needs to change to make life easier for the inspectors. This is the approach in the realm of funding/administration and IT and I see no reason why the same ‘one size fits all’ approach shouldn’t also be imposed by the CQC. Who exactly is wearing the trousers here, GPs or the CQC? It should be the CQC but reading this article you might start think the interests of GPs somehow matter - lol , the very idea!
    We need more ‘working at scale’ - so much easier to administrate, so much more ‘efficient’ and oh some much easier to inspect.
    General practice must comply ...or die.

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  • Remember Einstein's dictum: not everything that can be measured matters; and not everything that matters can be measured.

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  • I wonder who is regulating the researchers from the King's Fund and University of Manchester?

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  • @lateral think
    Brilliant! By those criteria the CQC should not exist.

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  • Anything to do with Prof Field's impeding retirement???!

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  • So now they tell us that the CQC needs to improve as the chairman jumps ship. Thanks a lot! Can we claim compensation for the trauma that the CQC has inflicted on many grassroots GPs! If the CQC has done anything good, which I am not convinced of, then it has been counterbalanced by its damaging behaviour!

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  • Vinci Ho

    You see , this evaluation report is already very soft-toned and polite . Fundamentally, it is a big slap on the face for CQC.
    We always say medicine is an art not a science exactly because of the argument ‘ one size cannot fit all ‘ . Something called ‘professional common sense ‘ as well as flexibility should be the core principle on implementation. We have recent arguments about different targets to reach for different groups of patients, as far as management of BP , diabetes and stain on primary prevention , are concerned.Clearly , the same principle should apply to regulatory bodies.
    Problem , so often , technocrats and politicians need to justify their own ‘value of existence’ by quoting statistical figures which are pieces of science deviating from reality in individual circumstances. We saw Mr Hunt, with a bit of political witchcraft,did that very well previously on various issues.
    CQC , GMC and NICE are all doing this. Call it ‘unconsciously blind’ if you are diplomatic. ‘Unforgivable’ if you are critical .......😑

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  • I visited the CQC earlier in the year to try to persuade them to shift their focus more towards measures of outcome than process. Moreover the University of Bristol had just published details of an excellent outcome tool for primary care. But I don`t think the CQC folk could really grasp what I was suggesting - but as none of them were in practice or GPs this should not have come as a surprise to me. Pity!

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  • I think Einstein also defined insanity

    Insanity: doing the same thing over and over again and expecting different results.

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