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Practices will have to ‘live up to’ quality statements under new CQC approach

by Caitlin Tilley
3 August 2022

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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 quality 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 quality 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 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: ‘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 said: ‘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.

A version of this article was initially published on our sister title Pulse.

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