Inspections of general practices based on best available data


For the first time, information on every general practice in England has been analysed and published by the Care Quality Commission (CQC) to show the public how it will decide which surgeries it will inspect and what it will focus on.

The ‘intelligent monitoring’ of general practices published today (Monday 17 November) are made up of different types of evidence on patient experience, care and treatment, based on sources including surveys and official statistics.

They help CQC decide how it should prioritise its inspections under its new and in-depth regime, which it rolled out formally last month. This is so that it can be confident that people receive care that is safe, caring, effective, responsive to their needs, and well-led.

It is part of CQC’s new regulatory approach that features specialist inspection teams, including GPs or practice nurses and trained members of the public who inspect services against what matters most to people who use them. CQC has been using evidence to prioritise its inspections of acute NHS trusts since last October.

Today’s analysis reveals that almost eight out of ten general practices in England appear to be of low concern, based on the available data and almost 3,800 are in the lowest category.

While CQC can only judge the quality of care within a service once it has carried out an inspection, the analysis indicates which services appear to be doing well, alongside where people may not be receiving high-quality and compassionate care.

The publication follows the regulator’s announcement yesterday of the first general practices to be awarded ratings of Outstanding – Salford Health Matters in Eccles and Irlam Medical Practice 2 in Salford.

Within the next two years, CQC will have inspected and rated every general practice in England as Outstanding, Good, Requires Improvement and Inadequate to help people make informed choices about their care and encourage improvement in quality.

Professor Steve Field, Chief Inspector of General Practice, said: “There is a lot of good and outstanding care taking place across the country as our data and recent reports show.

“While it is positive that 78% of general practices are currently a low concern based on the available data, there is no reason for complacency and standards must continue to improve.

“It is important to remember that the data is not a judgement as it is only when we inspect we can determine if a practice provides safe, high-quality and compassionate care.

“The data is a further tool that will help us to decide where to inspect and when.”

Mike Bewick, Deputy Medical Director at NHS England and former GP, said: “General practice, with everyone having access to a family doctor, is one of the great strengths of the NHS. We’re pleased this report shows that despite the increased pressure on GPs there are so many good and outstanding practices across the country.

“As with all parts of the NHS there is some variation, this data will help GPs understand where there could be improvement. The Five Year Forward View published by the NHS highlighted the need for an increase in the share of funding for General Practice.”

Dr Charles Alessi, Co-chairman of the National Association of Primary Care, said: “We welcome the emphasis on transparency and quality in the new inspection regime for General Practice.

“The fact that outstanding practice has already been identified is very encouraging and we looking forward to working closely with CQC to further develop models of monitoring to both lessen the burden of inspection and enrich the experience on the practices.”

Norman Williams, Immediate Past President of the Royal College of Surgeons, said: “I am pleased that CQC is being transparent by making data on all aspects of health and care available.

“During my time as president this is something that I championed as information helps to drive improvements. It is absolutely right that patients are aware of the quality of the services that are provided so they can make choices about their care”.

Katherine Murphy, Chief Executive of the Patients’ Association, said: “We often hear about the difficulties people have trying to get an appointment with their GP. It is an area that general practice has to get right.

“Our own reports have highlighted the access that people have that matches CQC’s analysis.  We hope that CQC’s work in highlighting this major issue will act as a catalyst and there will be some positive changes.”

CQC has produced thirty-eight indicators on whether patients at the surgery could be at ‘risk’ or ‘elevated risk’ beyond what would be expected normally for each of these.

CQC has then placed every practice into bandings from one (highest perceived concern) to six (lowest perceived concern) to help plan inspections from next year.

Within this, 78% (6,076 practices) are in the lowest four bands; 3,797 of which are in band six.

The 1,200 practices that are in bands one and two will be considered for inspection from next year, so that CQC can determine the quality and safety of care within them.

The bandings are not judgements: these only happen following inspections.

CQC plans to update this information every three months so that it can continue to respond to issues as they emerge and to share these with providers and the public.

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