The CQC will replace its current methodology for GP practice inspections with a set of ‘quality statements’ that practices must ‘live up to’ in order to pass.
The new inspection regime will continue to determine whether practices are ‘safe, effective, caring, responsive and well-led’, which are the CQC’s five domains.
However, instead of using ‘key lines of enquiry’, which is the current methodology, the CQC has formulated statements based on these five domains.
These will include statements such as:
- ‘We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.’
- ‘We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.’
- ‘We have clear responsibilities, roles, systems of accountability and good governance. We use these to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.’
- ‘We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.’
There are around 34 statements in all, across the five domains (see box), but it is unclear when the new regime will be implemented.
The commitments show ‘what is needed to deliver high-quality, person-centred care’, the CQC said.
‘The statements replace our existing Key Lines of Enquiry (KLOEs) and describe what good care looks like,’ the CQC added.
The change comes as part of the CQC’s new approach to regulation and move to a single assessment framework, as the CQC said ‘we need to change how we work’ to ‘deliver our ambitious strategy’.
Summary: what the quality statements focus on
- Safety: learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risks, safe and effective staffing, infection prevention and control and medicines optimisation.
- Effectiveness: assessing needs, delivering evidence-based care and treatment, teamwork, supporting people to live healthier lives, monitoring and improving outcomes and consent to care and treatment.
- Caring: kindness, compassion and dignity; treating people as individuals; independence, choice and control; responding to people’s immediate needs; and workforce wellbeing and enablement.
- Responsiveness: person-centred care; care provision, integration, and continuity; providing information; listening to and involving people; equity in access, experiences and outcomes; and planning for the future.
- Well led: shared direction and culture; capable, compassionate and inclusive leaders; freedom to speak up; workforce equality, diversity and inclusion; governance, management and sustainability; partnerships and communities; learning, improvement and innovation; and environmental sustainability.
Meanwhile, LMCs have warned that the CQC are not taking the effect of the pandemic on GP practices into account when inspecting.
Lancashire and Cumbria consortium of LMCs said in a bulletin that the regulator was ‘holding practices to a standard that is seemingly now unachievable’.
It said the LMCs have ‘recently spoken to a couple of practices that have fallen foul of CQC’s more stringent “post-pandemic” approach and have been supporting them where possible’.
Chief executive of Lancashire and Cumbria consortium of LMCs Peter Higgins told Pulse the CQC is ‘totally ignoring’ the impact of the pandemic on GP practices.
He said: ‘There’s no reference in their reports to the pressures that the practices are under, the fact that they’ve got so many vacancies, or the fact that they’re also running their vaccination campaign at the same time.
He added: ‘I look for some understanding from them and some moderation, when in fact they’re becoming more zealous than ever. It feels as if they’ve got a point to prove.
Mr Higgins said: ‘It is something that has been shared across quite a few LMCs, that have had the same experience. What we’d like to do is raise it at the national level, so we can have some national discussion with the CQC leadership team.’
Kent LMC also said in May that it was ‘aware that [CQC] are being rigorous in inspecting all practice records, policies and processes’.
A CQC spokesperson told Pulse: ‘As a responsive regulator we need to work in a way that reassures people about the quality of care they can expect to receive while also being sensitive to the unparalleled pressures facing providers.
‘This is why our approach has always been designed through consultation with the profession, and why we continue to look at how we can minimise the impact that regulation has on providers now and in the future through our ongoing transformation programme.’
The CQC said last week it is ‘considering what is the best model’ for primary care regulation, while it announced that its hospitals inspector will take over regulating primary care on an interim basis after its chief inspector of primary care quit.
READERS' COMMENTS [23]
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FFS – how many never seen a patient in the current crap NHS non-doctors spent tax payers money dreaming that pile of dross up?
Ram it.
((Very) Early) retirement just keeps getting closer and closer. Only a few years to go now at most – actually hoping for the nudge that will bring that even nearer. Keep going chaps…keep going.
Ha. There’s only so many GP surgeries you can close down until you realise you DON’T have anymore estates to actually do anything anymore meaningful in the NHS. Keep closing them.
Prof Field ran away (and is now integrated GPs and hospitals and Americans) and Madan and Hunt – so did Hancock and little legacy from Kanani and Waller – and so will the next so and so.
Let’s go for 250 closures per year – or wait – maybe 500. Let’s add to the evidence table – not remove from it.
Let’s not actually consult General Practice on this – just work with the “agenda” of fear and monitoring.
It is so boring.
Let’s see where that and your App solution get you.
I see all the dentists are open btw.
All rated perfectly well. And loving it. A nice little pat on the back and kind inspection. And plenty of private dollar privilege and health inequality. You don’t see any audit being done about access, inclusion and complaints. Get over yourself.
Smell the ash, and gutter. Or come work in it, actually.
Dr N’s comments are 100%…. how on earth do they dream up this stuff. They are so detached from reality. Any yet more GP’s rush for the door.
The longest suicide note in history. (fwiw 1983)
We can but hope eh?
And where is the CQC report stating the required staffing to fulfill a role, where is the caveat that when staffing is below that level that it’s not surprising standards fall and should be judged accordingly! Scotland seems to manage without this nonsense, usually you can just ignore an irrelevant irritant but as can be seen, this organisation does actual harm, by adding to the general grief that fuels the exodus!
And what if a practice does not live up to this arbitrary drivel? The practice gets shut down? Is there not already a crisis in General Practice recruitment and retention? Who makes this sh**e up.??
Sigh.
Cannot wait for cost cutting needed to restore punlic finances to result in the abolition of this s…show.
Buried deep amongst the summary’s word salad of trendy empty meaningless woke middle-management speak are some truly sinister phrases.
“Responding to people’s immediate needs” – we’re not an emergency service, what does this imply?
“Equity in access” – note, not “equality “, should we allow access of one group of people whilst denying it to another?
“Diversity and inclusion” – should we only interview male candidates to correct the shocking over-representation of females as receptionists?
“Environmental sustainability” – well with prices rocketing at least we’ll be keeping the radiators turned off.
It’s easy to laugh at the summary’s risible attempts to dump this PC bilge on to General Practice, but these useless clowns wield very real power.
Dear All,
A few comments; “to any relevant changes in their needs”, Any? not just their medical and psychological? Finance, housing, employment?
“We share information” – I’d like to see the word “necessary” inserted, so as to comply with the law.
Happy to comment more when full text available.
Regards
Paul C
Dear All,
“‘This is why our approach has always been designed through consultation with the profession”. Could we see the evidence to support that statement?
Regards
Paul C
When I think of the true heroes and heroines of General Practice past and present, and then read this management drivel trying to enforce this onto GPs it makes me feel truly depressed
To be honest probably get a fairer/reasonable/rational assessment of your practice if used Bottom Inspectors from Viz
Made good & bad calls in life: bad was few years working for them, good was leaving them.
Agreed, sooner they are scrapped after financial review the better.
Any chance of the BMA organising a mass refusal to co-operate or fund these parasites?
When you read the summary panel, one has to say these are all admirable goals – which would be incredibly beneficial to see applied to NHSE and the government with respect to how they deal with all NHS staff and organisations.
These recommendations are NOT the preserve of General Practice to instigate, they are key drivers of how the NHS should be responding to patients and staff from the very top level – and about as likely to happen as Boris admitting he’s a complete incompetent lying moron!
The staffing and funding is rubbish. How about just accepting a good enough NHS instead of a perfect saintly one?
Or just live up to unprecedented awareness of the sick structures around you. New world. Your matrix is falling.
Another nail in the coffin. The government needs to prepare now, to take ownership of general practice instead of relying on private companies, which has been the case since the inception of the NHS. Once the current cohort of old school GPs has retired (5-10 years) there simply will not be enough GPs gullible enough to sign up to and sustain the silly independent contractor status model. And if HMG thinks that pharmacists, PA’s and non-existent imported overseas GPs will be its salvation, it is badly mistaken.
The imposition of increasingly unrealistic standards without any reference to or allowance for the huge decline in real-terms funding is utterly inexplicable and risks finishing off NHS general practice.
How a regulator can be allowed to suddenly make up new sets of non-contractual standards is beyond belief.
I’d like to see strong responses to this from RCGP and BMA: how about fighting back and saying the obvious – CQC has got out of control and is not fit for purpose.
It’s almost as if the CQC is riddled with corruption.
Surely not.
Remember KC Carl Beech was employed by CQC.
Enough said.
CQC are setting up goalposts for unrealistic targets in a increasingly difficult working environment.
We train GP trainees to be good enough and then measure them to a standard of near perfection.
The level of scrutiny by CQC once they decide they have a target in mind would destroy 50 per cent of colleagues if they were targeted in the same way, especially against single handed and ethnic minority groups. This is clearly institutional racism in action but they are currently a law unto themselves and beyond challenge
The BMA needs to stand up for GPs now or face a mass resignation from it for being ineffective and pointless.