New model and rating system
With headlines such as ‘Worst offenders could be shut down under plan by watchdog to improve standards’ and ‘Improve or be shut down’, it’s clear that panic has set in about what action the CQC will take against those GP practices who fail to meet the standards. This week the CQC announced plans to introduce a new ‘special measures’ regime for GP practices. The scheme will see practices offering poor care given deadlines to make improvements and faced with closure if they fail. Whilst the CQC’s purpose is, and always has been to inspect performance against national standards, the way they do this is changing with the introduction of the new inspection model and rating system from October this year. They will continue to take action, including enforcement, when they find services aren’t meeting the standards.
The heart of patients’ experiences
The aim of the new inspection model is to get to the heart of patients’ experiences. The CQC inspection teams will look at the quality and safety of the care provided based on the things that matter to people. They will look at whether the service is:
- Safe
- Effective
- Caring
- Responsive to people’s needs
- Well-led
Through this updated approach the CQC believes it will have a better understanding of the quality provided. It will also allow it to consider and feedback on new areas around leadership and governance. The new rating will be on the basis of whether GP practices are ‘outstanding’, ‘good’, ‘require improvement’ or ‘inadequate’.
New approach
We saw with the Quality and Outcomes Framework (QOF) that the same standards, checks and monitoring were repeated year after year, for almost 10 years, to the point that it simply became a paperwork exercise and no longer served its purpose to drive quality in primary care. I welcome the CQC’s new approach and efforts to review their inspection process and not just focus on policies and procedures year after year. The CQC has a specific purpose, and an important one at that, to drive up standards in those GP practices that are not providing the services that people ought to have.
Countdown to closure
Under the new proposals, when a GP practice is rated as ‘inadequate’, they will be given six months to improve. Practices that fail to make improvements will be put into special measures, after which they will be given a further six months to meet the standards. In some cases, when the CQC believe poor care is putting patients at risk, or that a practice is not capable of improving on its own, they will be put into special measures straight away. At the end of the period in special measures, if the CQC continues to judge the practice to be inadequate, their CQC registration will be cancelled and subsequently their contract with NHS England will be terminated.
We know that most GP practices provide good care, but this is a stark warning for those who really need to pull their socks up. They will have to start taking the CQC very seriously because this will have severe implications for their business, their staff and, of course, their patients!
