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Don't bury your head in the sand
As expected, only a small number of practices which have been inspected have had a 'Requires Improvement' or 'Inadequate' rating. Whilst some of the reasons for these ratings may be beyond the control of the practice, such as inadequate premises, recruitment difficulties, and so forth, many of the findings could probably be avoided. There is so much information out there now to help GP practices to prepare for a CQC inspection that you’d have to have your head in the sand not to be aware of it and the CQC is not going away any time soon!
Use the CQC mythbusters
Practices have had to register with the CQC since April 2013, so for almost three years they've been working their way through preparing for inspection. In that time there has been considerable change with the inspection process, the inspection teams and, of course, the reporting. From October 2014 the CQC began to roll out its new inspection regime, with the aim of inspecting and rating every GP practice in England by April 2016. This has resulted in over 60 mythbusters, available on the CQC website, to clear up common myths about the inspections and to share guidance to best practice. They are incredibly useful and a valued reference guide, particularly when seeking clarity and the rationale about a particular issue.
Examples of inadequate practice in GP inspections
The CQC's new web-tool uses anonymised examples from inspection reports to highlight the common features of inadequate practice that they have so far found in their inspections of GP surgeries in England. The CQC shares these short case studies as part of its role to encourage improvement in patient care. Each case study gives a common example of inadequate practice and the negative impact that this has had on the practice and on people receiving care. There are also links to further guidance or advice about the relevant topic.
There is a link to the CQC's guidance below, but, in summary, the following topics in the five key areas seem to be recurring when it comes to inadequate ratings:
- No analysis of significant events
- Safeguarding protocols not robust and staff not appropriately trained
- Not screening staff properly when recruiting
- No clinical audits or evaluation of the service
- Not caring for patients using up-to-date best practice
- Little concern for patient's privacy and dignity in reception and waiting areas
- No lists of people at the end of life or sharing this information with out-of-hours services
- Poor availability of appointments at times which suit patients
- Difficult to contact the practice by telephone
- No same-sex clinicians
- Absence of vision for the organisation
- Lack of clarity in roles and responsibilities to run the practice day-to-day
- Poor visibility of leaders and no whole-practice meetings
Aim for outstanding
In addition to examples of inadequate practice there are countless examples of good and outstanding practice. The CQC website displays all the latest inspection ratings so it’s worth having a look to see if some of the services you offer would provide evidence of excellent standards of care, and they may even outweigh any borderline any inadequate practices.
Alison Lowerson – QCS Expert GP Practice Manager Contributor