After 15 minutes providing the CQC chief inspector (aka ‘the chief’) with a thorough overview of the PPG things started to get a bit more interesting and I must admit that I found the remainder of the ‘discussion’ valuable, insightful, useful and in a few cases ‘eye-opening’! As best I can, I’ll try and group the questions and discussions that followed, as I think this may be advantageous!

The initial set of questions focused on what I can only describe as PPG-practice relations. From memory these included:

• Which staff members attend PPG meetings?
• Do the practice take the PPG seriously?
• Did the practice ask the PPG to help prepare for the CQC visit?
• Give examples of how the practice have acted on PPG advice
• Do the practice share complaints with the PPG?
• Do the practice share incidents with the PPG?
• Do the practice share friends and family test/survey results with the PPG?
• In our opinion, do the practice take feedback from patients seriously?
• Did the practice keep us informed of staffing changes?
• Did the practice provide us with timely information if we requested it?

This impressed me and I’ll say right now that practices that don’t take their PPG seriously and try to cultivate it are likely to be in for a rough-ride from the CQC, who clearly place a lot of stock on patient engagement. Frankly, ‘the chief’ turned out to be a champion poker player and simply took notes whilst not making any facial expressions as we answered each question in turn. However, you didn’t need to be Stephen Hawking to work out that as we shook our heads and answered ‘no’ to 50% of the above questions, this wasn’t exactly music to his ears! And far be it from me as a PPG Chair to tell practices what to do, but via discussion it became clear that the practice must give a presentation to the CQC team, which was news to all PPG members! I suspect the ‘outstanding’ practices get their PPG members heavily involved in this.  Surely it makes sense to ask PPG members to review the presentation, or have the practice team give mock presentations to the PPG or better still ask a few PPG members to sit on the presentation to the CQC or give a small part of it! It felt like we missed an open goal here although I’ll never know, as ‘the chief’ gave nothing away!

The next set of questions focused on what I would describe as PPG members experiences and perceptions of the practice. Again, a bombardment of questions from ‘the chief’:

• Views/experiences on the appointment system
• Views/experiences on contacting the practice by phone
• Views/experiences on ordering prescriptions
• Did the practice offer home visits?
• How did the practice deal with medical emergencies?
• Were appointments long enough to meet the needs of patients?
• Did we know how to make a complaint and the complaints procedure?
• Are the receptionists courteous and helpful?
• Was the practice always clean?

This seemed like a pretty reasonable set of questions, although it was curious to note that at no point did ‘the chief’ ask for our views and experiences on the quality of care given by the clinical staff. Of course, while I appreciate the above questions are very important, for me they focus on what I call the ‘hotel’ aspects of the service. Personally, I and the other PPG members present agreed that we would have liked more questions focusing on the care, advice and compassion that we receive at the surgery.

The final series of questions can only be described as a mixed bag! ‘The chief’ started with ‘are there enough doctors at the practice?’ Cue blank looks from us non-healthcare experts! Surely there must be a simple algorithm to work out how many doctors a particular practice need! And moreover, even if this question is important, why was it not followed up with ‘are there enough nurses?’

We were then asked ‘do the PPG conduct a patient survey’. Answer ‘No’. ‘The chief’s’ pokerface slipped at this point (it was 75 minutes into the discussion) and there was the briefest of frowns. Sensing ‘the chief’s’ disappointment we followed this up by saying the PPG had made a conscious effort not to conduct anymore surveys given that we already ask patients to complete an annual survey and invite them to fill in FFT cards. This didn’t seem to appease ‘the chief’, which annoyed me. I daresay some PPGs do really good surveys but how many out there create unbiased questionnaires without leading questions that are completed by a representative number of patients? I’d bet on not many! If the CQC use PPG surveys to assess practices I certainly hope they check the PPG survey is fit-for-purpose and benefits the patients.

Having said all the above I was very impressed with ‘the chief’s’ final series of questions in relation to the appointments system. Coming into the meeting all PPG members agreed that this was the Achilles heel of the practice and you could just tell that ‘the chief’ had figured this out. I guess that by looking at patient survey data and feedback on NHS Choices he didn’t have to call Inspector Morse to assist with his diagnosis, however, it was encouraging to see that the CQC had identified the key problem facing our practice.

So there you have a PPG Chairman’s reflections on a CQC inspection. Overall, a ‘good’ experience but not ‘outstanding’. We await the full report. I’ll write another blog to review the final part of the process in due course.