The CQC has confirmed that its new inspection programme for GP practices that are considered low risk and haven’t been assessed for some time is here ‘for the foreseeable’.
Speaking at Management in Practice’s conference in Bristol this week, Helen Rawlings, director of primary care and community care, London and South at the CQC, said the Returning to Good Outstanding project launched in March has no set end date.
Under this approach, assessment focuses on GP practices that hold a current rating of ‘good’ or ‘outstanding’; last had their inspection report published between 2017 and 2022; and are considered lower risk. It also only applies to practices and not GP organisations.
Ms Rawlings revealed that assessment, which comprises a site visit, is based on 10 non-clinical quality statements, which are:
- Safe environments
- Safe and effective staffing
- Infection prevention and control
- Supporting people to live healthier lives
- Monitoring and improving outcomes
- Kindness, compassion and dignity
- Equity in access
- Equity in experiences and outcomes
- Shared direction and culture
- Governance, management and sustainability.
The programme runs alongside the CQC’s ‘business-as-usual assessment activity,’ she said.
Ms Rawlings further explained: ‘We have just got started and practices that fit the criteria for selection should be aware it’s happening,
‘We are currently scheduling site visits through to September and October and are going to keep reviewing this programme and get feedback.
‘We have no set end date for it and is an approach that’s here for the foreseeable.
‘But we will evaluate it again when the new assessment frameworks come on board.’
A draft sector-specific assessment framework for for primary care and community services was unveiled last month and is currently out to consultation.
Although it’s still structured using the five key questions (safe, effective, caring, responsive, well-led), key lines of enquiry (KLOEs) will be reintroduced replacing the current quality statements. Clear descriptions of what each rating means in practice will also be reintroduced.
Ms Rawlings said: ‘There has been a dramatic cut in the number of components that will be assessed from 34 to 26.
‘The decision to return back to KLOEs was based on the perception of quality statements and wanting to reduce duplication.’
She added: ‘For now, until the frameworks have been finalised there is no formal change and the current system remains in place. Practices will be updated.’
Major changes at the CQC have been implemented following a number of reviews identified critical problems and shortfalls.
‘We have had a bumpy couple of years’, Ms Rawlings admitted ‘which we are now coming out of, I’m pleased to say.’
As an update, she said that there had been improvements to the lengthy time delays between an inspection taking place and a report being published.
‘About a year and half ago we had 500 reports stuck in our platform that couldn’t be published because of IT issues.
‘That backlog has been cleared,’ she said. ‘And it now takes around 50 days from the time of inspection to a report being published, which is a return to what it had been before.’
The consultation for the draft assessment frameworks closes on 12 June. The next steps for the CQC this year, Ms Rawlings said, included focus groups being held in June, new digital and technology systems being designed to support the regulatory process; testing and refining of the draft assessment frameworks as well as registration processes and then implementation.
Meanwhile, the CQC will be given new powers to protect patient safety and more time to initiate proceedings against providers who fail to provide safe care, as part of the new NHS ‘modernisation’ bill.
In a policy paper released this week, the Government said that the bill aims at ‘strengthening patient safety’ and that extending the time limit for CQC to initiate proceedings from three years to five will ‘give more families the justice they are seeking’.
The bill will also abolish the Health Services Safety Investigations Body (HSSIB) and transfer its functions to the CQC. Powers currently held by HSSIB safety investigators will be carried over to CQC, including powers of entry and the ability to demand and secure documentary and other evidence.
HSSIB’s role in education and training in patient safety investigation skills for NHS and healthcare staff will also be transferred to the CQC.
