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Future of CQC inspection revealed

7 November 2013

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Exclusive The new chief inspector for primary care at the Care Quality Commission (CQC) has outlined how his team will work with clinical commissioners and inspect practices in an exclusive interview with Management in Practice.

Professor Steve Field said it was his aim to visit each clinical commissioning group (CCG) every six months to look at a quarter of their primary care health services, including GP practices, prisons and mental health trusts.

After the first meeting, where applicable, following CCG visits will be themed around areas such as prescribing in care homes or substance misuse and they will be coordinated by inspection managers – job title yet to be confirmed – who will work with two to three CCGs.

There will be two parts to every GP practice visit – intelligence gathering and inspection.

The inspectors, all of whom will have been through the nascent CQC training academy, will first look at practice data including prescribing patterns, pathology requests and patients’ feedback.

‘Celebrating excellence’ 

Intelligence gathering will be supported by a piece of work soon to be launched by the CQC, in collaboration with NHS England, the British Medical Association and the Royal College of General Practitioners. 

Professor Field, a GP who spends one day a week at Bellevue Medical Centre in Birmingham, has been inspired by the work of Ofsted, the official school inspectors. 

“Two years ago schools were very scared about the visit [from Ofsted] but now it’s all about the pride of being outstanding. There are two things I like from the Ofsted idea, we can rate but celebrate excellence as well as sorting out practices which aren’t very good but it’s not our role to be the developmental support organisation. NHS England is the contract holder so we are here to protect patients.”

He reiterated his intention to rate practices as ‘outstanding’,’ good’, ‘needs improvement’ or ‘inadequate’. Prof Field also indicated that he would breakdown these ratings further by sector area such as frail elderly, working age population and mums and babies.

“When I first started looking at this I thought it’d be OK to say something is ‘outstanding’ but actually the feedback from a number of GPs is that they’d quite like the idea if having it more granular so if you were in Eastbourne, which is mostly elderly, you’d want to be a practice good for the elderly,” he said.

Prof Field also liked the way Ofsted writes a letter to the pupils after they have been on a visit telling them what they think about the school.

He said: “I am thinking about doing a similar thing, obviously we couldn’t write to all patients because that would be prohibitive, but I am thinking about writing an open letter to the practice which they would publish on their website and the local press would publish as well as doing a full report.” 

For general practice, visits will be led by a trained inspector and involve a team of about five including a GP, a practice manager or nurse, an expert patient and possibly a GP registrar.

Current notice for a planned inspection is about three days but as a GP Prof Field does understand the disruption these visits can cause and is looking at giving closer to three weeks notice.

All these plans have yet to be finalised and are subject to the CQC board’s approval. There will be two publications for the CQC around Christmas looking at the first 1,000 practices to be inspected and at simplifying compliance regulations.