1

Inspection of General Practice

Ian Jeavons

Lynne Lord

CQC – Primary Medical Services

7 Inspection teams covering North of England

Each team consists of 9 Inspectors

Each team covers a geographical patch of CCG areas

Each team managed by an Inspection Manager

Currently teams focus on different CCG Area each month

Plan to Inspect / rate all GP Practices by Sept 2016 ( Outstanding, Good, Requires Improvement or Inadequate)

2

Planning Inspections

Inspector builds team around Inspection

Inspector analyses information about the Practice

CQC seeks information from CCG / NHS England

Practice get 2 weeks notice of inspection

Practice asked to submit some information in advance of inspection

Practice receives comment card box / comment cards

Communication about how the inspection day will be structured

Practice to prepare 30 mins information overview for delivery on the inspection day

3

Inspection Day

Typically 8:30am – 5:00pm ( this can vary)

Practice overview / 30 mins

Interviews / Discussions with staff / patients

Review of policies / procedures /records

Checking how things are managed in the Practice

Observations

Focus on population groups

Feedback session

4

Is the Practice Safe?

Safe track record

Learning and Improvement from safety incidents

Reliable safety systems and processes including safeguarding

Medicines management

Cleanliness and Infection Control

Equipment

Monitoring safety and responding to risk

Arrangements for dealing with emergencies and major incidents

5

Is the Practice effective

Effective needs assessment

Managing, monitoring and improving outcomes for people

Effective staffing

Working with colleagues and other services

Information sharing

Consent to care and treatment

Health promotion and prevention

6

Is the Practice Caring?

Respect, dignity , compassion and empathy

Care planning and involvement in decisions about care and treatment

Patient/ carer support to cope emotionally with care and treatment

7

Is the Practice Responsive?

Responding to and meeting peoples needs

Tackling inequality and promoting equality

Access to the service

Listening and learning from concerns and complaints

8

Is the Practice well led?

Vision and strategy

Governance arrangements

Leadership, openness and transparency

Seeking and acting on feedback from patients, public and staff

Management lead through learning and improvement

9

Population Groups

Older People

People with long term conditions

Families, children and young people,

Working people (including students)

People whose circumstances make them vulnerable

People experiencing poor mental health

10

After the Inspection?

Inspector analyses Inspection findings

Lead Inspector produces draft inspection report awards ratings

Draft inspection report goes through QA process - regional / national

Draft inspection report sent to Practice for Factual Accuracy comment

Final inspection report is published

Practice asked for Action plan (if required)

Practice can request rating review

11

12

Ratings: four point scale

High level characteristics of each rating level

Innovative, creative, constantly striving to improve, open and transparent

Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong

May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong

Severe harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve

Latest Published Inspection Reports with Ratings (1 Oct 2014 – 22 May 2015)

13

Outstanding (3%); Good (82%); Requires Improvement (11%); Inadequate (4%)

  Total North South Central London

Outstanding 29 13 6 8 2

Good 757 269 210 208 70

Requires Improvement 105 21 38 29 17

Inadequate 36 13 7 6 10

  927 316  261  251  99 

Overall rating by domain(1 October 2014 – 30 April 2015)

14

Tips

Emphasise what the Practice does well (innovative work)

Emphasise any learning and improvement from any challenges

Don’t be caught out with common issues:

Out of date medicines being used / not secure

Staff recruitment evidence

Lack of awareness about safeguarding

15

Any Questions?

Any Questions ???????

16