CQC sets out plans to scrap routine on-site GP practice inspections


The CQC has set out plans to move away from routine on-site inspections of GP practices, as part of a consultation process to improve how the it assesses primary care services.

Changes proposed the CQC could see practices assessed less frequently, with on-site inspections only triggered by ‘changes in quality’ as opposed to happening within set time frames for all practices as is currently the case.

The regulator has also revealed that it is planning to introduce a simplified ratings system for GP practices during 2021, arguing that the current method is ‘too complex’.

Plans around new-look practice inspections were revealed in a consultation document published this week, which build on the regulator’s work to streamline its approach as a result of the COVID-19 pandemic.

Practice inspections

The consultation document said: ‘We want to move away from using comprehensive, on-site inspection as the main way of updating ratings.

‘Instead, we want to use wider sources of evidence, tools, and techniques to assess quality. This includes where we’ve gathered appropriate evidence following focused or targeted inspections, assessments without a site visit, and if we need to take significant enforcement action to protect people.

‘[But] we’ll still carry out an on-site inspection where we have information about significant risks to people’s safety, and to ensure we protect the rights of vulnerable people.

It added that a ‘less rigid approach’ would enable inspectors to provide a more up-to-date overview of the quality of care across England. The changes would also mean that the CQC not return to ‘using the current inspection frequencies’, the document said.

CQC rating

‘We want to stop describing frequency of assessment in terms of “inspection” and instead by how often we review quality and update ratings. So, we’ll focus on reviewing, confirming and changing ratings in a variety of ways – this won’t just be limited to after a physical on-site inspection or a full assessment of quality,’ the CQC said.

The regulator also plans to report on changes in quality of services ‘more quickly than it did before’ by using a combination of targeted inspections, national and local data and insight from other organisations and partners.

The consultation process, which runs until 23 March, outlines plans for the regulator to change the current assessment system and move towards a system which assesses practices on two levels.

The first level will be a rating for each key question for the location or service. This will be based on relevant evidence of how GP practices personalise people’s care and provide care for different groups of people. The second will be an overall rating for the service, which will be an aggregated rating informed by the regulator’s findings at level 1.

Primary care services

At present GP surgeries are inspected and rated using five key questions – is the practice safe, effective, caring, responsive and well-led? The CQC also assesses people’s experiences of care in six population groups.

The document said: ‘This change doesn’t mean that we’ll stop looking at how practices provide personalised and proactive care to their local populations and consider people’s different needs when receiving primary medical care. This will still be a key part of our assessment activity. It means that we won’t provide an additional and separate rating for different groups of people for the effective and responsive key questions.’

GPonline reported last December that the CQC had inspected five GP practices a week in England since the second wave of the COVID-19 pandemic began, including 56 on-site inspections in the 12-week period from the start of September to 24 November.

Earlier this week the CQC revealed that it was planning to investigate ‘longstanding concerns’ that black, Asian and minority ethnic (BAME) GP partners may be more likely to score lower in practice ratings.

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