Last month, the Care Quality Commission (CQC) resumed inspections for some GP practices.
Covid-19 has brought changes to the regulator’s approach – with routine inspections paused at the start of the pandemic and a transitional regulatory approach introduced from October.
And now inspections of services that had previously breached regulations, as well as those rated as ‘requires improvement’ without any regulatory breaches, are underway again.
Management in Practice looked at three reports of practices inspected between 13 and 30 April and rated ‘good’ to see how these services had made improvements to their services.
Cancer screening
Central Surgery, in Westcliff On Sea, had taken steps to improve uptake for cancer screening, including introducing extended hour nurse clinics each month to improve working age patients’ access to cervical screening services.
The practice also worked with a ‘call and recall’ policy to reach patients who had not responded to appointment letters, in addition to staff opportunistically reminding patients during remote and face-to-face consultations.
The CQC said that while verified data showed the practice had not met the 80% target rate, unverified data showed it had achieved a rate of 82.3% for eligible people aged 50 to 64.
Central Surgery had also improved how it monitored patients with long-term conditions such as diabetes. In particular, the practice had encouraged patients to record their blood pressure at home, providing those clinically vulnerable with the equipment to do so.
Using its recall system, the practice had also achieved 97% uptake of the flu vaccination for patients with diabetes, the inspection found.
Improving access and support during the pandemic
Meanwhile, an inspection of Dr Shantir’s practice, a surgery in London, revealed a ‘significant improvement’ in relation to telephone access, the CQC said, which had increased to 54% from 23% in 2018 and 34% in 2019.
Inspectors heard that the practice had been reviewing this with monthly reports, which provide daily and hourly breakdowns of telephone contact and patient demand, allowing for staff to divert their attention to appropriate services, such as appointments or results.
‘The practice told us that, using the telephone reporting system, they could see that staff had answered 87% of all calls to the practice in 2019 to 2020,’ the report said.
The practice also took into consideration patients’ religious and cultural needs, the CQC said, with GPs responding quickly – ‘often outside of normal working hours’ – to provide death certification for prompt burial.
It also worked with a local district nursing team to discuss and manage the care needs of patients with long-term conditions, with patients with multiple conditions having their needs reviewed in one appointment.
Staff hiring, training and support
Other practices were commended for their work to improve staff recruitment and training systems, to better patient safety.
At a previous 2019 inspection of Abbey Road Medical Practice, in London, the CQC found that recruitment systems were in place but ‘not consistently effective’. But the most recent review detected improvements, with arrangements ‘in place to ensure effective systems for staff HR checks including DBS, staff occupational and health immunity status’, and clinicians’ registration with the appropriate body checks.
The practice had also made improvements around clinical oversight of nursing and pharmacist staff, with monthly meetings now held with a GP to check prescribing, nurses and pharmacists supported to attend peer group meetings, and a lead GP providing regular one-to-one sessions for pharmacists.
‘Support for both practice nurses and pharmacists regarding individual patients was always available via the GP on call,’ the inspection report added.
