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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.’