It seems we’ve all faced delays of some sort recently – be it delays with our mail or widespread travel disruption – and the CQC are no different. Just before Christmas, they announced delays to all the planned changes for 2023. The revised plan suggests that the changes will now be implemented towards the end of 2023. The postponed changes include:

• Quality statements (which will replace the Key Lines of Enquiry)
• New Digital Regulatory platform (an IT system to allow easier registration work)
• Single Assessment Framework (the CQC’s internal IT system)
• Six new evidence categories
• New simpler and shorter reports
• The new internal employee teams and roles of operation managers, sector specialists, assessors, inspectors, regulatory coordinators, and regulatory officers

If you’re looking for a rationale for this, let me know when you find it! The reasons for this delay of a year seem to be vague at best and are referred to as “lessons learnt” from stakeholders. Of course, implementing an entirely new IT system whilst simultaneously restructuring all employees certainly is ambitious for the country’s largest regulator whilst still coming out of a pandemic, and with the NHS in crisis!

So, what’s the plan (and is there one)? The CQC have stated that they’ll be piloting these changes in the coming year. If you’re one of the lucky services that experiences one of these new processes, please do share your thoughts.

NHS Crisis Response 

Due to the current crisis, the CQC have decided to significantly reduce the number of inspections of GP practices. This press release explains that only GP practices where there is a “risk of harm to people” will be inspected. Generally, this means that only GP practices rated “inadequate” or with recently raised concerns will be inspected. A welcomed pause for many I’m sure, given the current workload!

So, what does that mean for 2023 regulation?

The Direct Monitoring Approach (DMA) calls remain ongoing. You may be surprised to learn that the CQC have a team of inspectors leading this process, and it’s here to stay, as mentioned in the Future focus: CQC in 2023 blog.

After the pressures of winter, CQC regulation will be as it was in 2022. For now, it’s important to remember that regardless of what the CQC change (internally and process wise), the regulations themselves (set by legislation) will be exactly the same. With that in mind, let’s take a look at what the CQC are focussing on.

2023 CQC Focus Areas

People are struggling to access care

The CQC commissioned surveys and projects to consider and analyse patient access in 2022 and found that over a third of patients couldn’t get a GP appointment. This means that the CQC will be focussing on:

1. Patient feedback and data generated by the National GP Survey Results
2. Phone lines data
3. Patient waiting times at the practice
4. Reception processes for booking appointments and urgent patients

On this basis, we recommend you consider the following questions about your own practice:

1. Are your phone lines fully functional?
2. What is the average waiting time for patients on your phone line?
3. Have you completed an audit of your phone-line data?
4. Are you getting patient feedback about access at your practice?
5. What have you done to improve access at your practice?
6. What would the patients in your waiting room say to an inspector about the waiting time?

In reports that we have reviewed, the CQC are currently focussing on this area in the Responsive and Well-Led key questions.

Ardens Searches

The detailed new approach to reviewing patient clinical records in 2022 caught a lot of EMIS practices out. You should think about the following questions if your service uses EMIS:

1. Have you run the searches?
2. Do you have a routine audit in place to chase patients for monitoring and follow-ups?
3. Do you have a protocol for patients who require monitoring?
4. Are you short-scripting patients who are not attending their follow-ups/safety-netting monitoring?
5. Are you managing and actioning MHRA safety alerts and auditing these patient lists?

Before 2022 and these searches, the CQC would simply review random patient records to reach a conclusion about your overall clinical work. Now, these searches mean that ALL the data included in your patient records can be used by the CQC to reach conclusions about your clinical work. Therefore, we strongly recommend that practices have an effective system in place for managing patient records and data.

Follow this monthly blog to keep up to date with CQC changes and we’ll also include tips and advice to help you achieve compliance.