CQC pledges to inspect “good” practices every five years

GENERAL medical practices in England rated "good" or "outstanding" will be inspected at a maximum interval of five years, according to a new report detailing the five-year strategy of the Care Quality Commission.

The regulator will also more frequently inspect those practices in which concerns have been raised with reports of poor care.

Practices rated "inadequate" will be inspected every six months, and those rated "requires improvement" at least every year.

These plans are set out in Shaping the future: CQC’s strategy of 2016 to 2021 which is based on what the regulator has "learned from more than 22,000 inspections" of health and social care providers.

The five-year inspection interval for good or outstanding practices will be "subject to... providing accurate and full data, and our confidence that quality has not changed significantly".

Among other major changes for primary care providers is a step up in unannounced inspections. The report states: "We will inspect a service earlier than planned if our insight identifies a level of concern that warrants it, or if we think quality has improved. With more effective monitoring information, more of our inspection activity will be unannounced."

The CQC also pledges to work more with partners such as the GMC/GDC and NHS England to reduce duplication for GP practices and dental providers, agreeing jointly what action should be taken by whom where there may be risks of poor quality care.

The report sets out how the monitoring of primary care will rely more on self-reporting: "To underpin our monitoring we will enable GP practices to share up-to-date information with CQC and other regulators and expect them to describe their view of the quality of care they are providing against our five key questions, as part of annual reporting processes, including what has changed over the year, their plans for improvement and examples of good practice."

By the end of 2016/17, the CQC will have carried out comprehensive inspections and rated all GP practices, urgent care centres, out-of-hours and 111 services. The majority of practices (86 per cent) have so far been rated as good or outstanding but 4 per cent have been rated inadequate (affecting 600,000 patients) and 10 per cent as requires improvement.

Inspections of all acute, mental health, community and ambulance NHS trusts and independent hospitals, and all standalone substance misuse services are expected to be completed by March 2017. So far the regulator has rated 61 per cent of NHS trusts and foundation trusts as requires improvement, with 7 per cent inadequate and 32 per cent good or outstanding.

Among other measures in this sector the CQC will "focus our inspections on core services (for example critical care, surgery), particularly those that require improvement or are inadequate and extend the intervals between inspections for those that are good or outstanding".

CQC’s Chief Executive, David Behan, said: "We’re developing our approach to reflect changes in the sectors we regulate – effective regulation doesn’t occur in a vacuum. But our role remains the same: consistently assessing quality of care using the information we and others gather; using what we know to help drive change and improvement; and acting swiftly to ensure people are protected from poor care.

"Inspection will always be crucial to our understanding of quality but we’ll increasingly be getting more and better information from the public and providers and using it alongside inspections to provide a trusted, responsive, independent view of quality that is regularly updated and that will be invaluable to people who provide services as well as those who use them.

"And we’ll make more use of focused unannounced inspections which target the areas where our insight suggests risk is greatest or quality is improving – with ratings updated where we find changes."