Is your practice safe, effective, caring, responsive and well led? These are the key issues brand new CQC visits intend to reveal when their ‘new and improved’ inspections start this month.

Yes, the CQC’s new inspection scheme is now live, and the body has pledged to inspect some 778 practices and out-of-hours services by the end of 2014. Practices will be rated from ‘inadequate’ to ‘outstanding’ as a result of inspections, and results will be published on the CQC website for patients to access so they can make ‘informed decisions’ on their care. Every practice should be inspected and rated by April 2016, with the first GP ratings expected to go live as early as November 2014.

Professor Nigel Sparrow, senior national GP advisor, said that CQC inspections will present practices with a chance to ‘demonstrate what’s good in [their] practice,’ though this claim has been met with mixed responses from GPs and Practice Managers nationally.

CQC has published an inspection handbook clearly explaining how GPs will be assessed and rated and what exactly the inspectors will be looking for when they visit.  Rating criteria are also broken down within the handbook.

Practices will receive no less that a fortnight’s notice ahead of an inspection, with each CCG area benefiting from four weeks’ notice ahead of the CQC’s arrival. In some circumstances, however – where specific issues have already been identified within a practice – inspectors can arrive unannounced.

The CQC handbook has been created to help providers and all their staff understand exactly what inspectors will be hoping to ascertain when they visit.

As the new inspections begin, CQC has published a handbook that sets out clearly how GPs will be assessed and rated, with the final version of the handbook –  complete with improvements – published just last week. These handbooks will be locked in for the next two years to allow all providers to get to grips with them as well as to enable inspectors a consistent level of assessment. Key questions remain unchanged in this final version of the handbook, but two extra lines of enquiry have been added under the ‘Effective’ heading, relating to the topics of patient consent and supporting healthy living.

The new handbook shifts its focus more closely to issues of staff involvement and performance, as well as involving patients in how they receive care. It also delves into the subject of practices having business continuity and adequate risk management plans in place. As well as all this, the handbook in its final draft also puts greater emphasis on patients’ access to services, posing questions such as:

• Are there enough appointments available?
• Can patients book appointments at times to suit them?
• Is telephone consultation available as an alternative?
• Are GP services running on time?

CQC inspection teams will also be permitted access to patient records in order ‘to assess the quality of care provided by the practice’. There are lots of service providers that can help you with your CQC inspection preparation.

Dr Robert Morley has recently spoken on how Practice Managers and GPs can maximise their surgery rating in his ‘Surviving CQC’ presentation. Some of his best tips included doing things like:

• Holding a strategy meeting with your senior management team
• Familiarising yourself with the new requirements (reading the handbook!)
• Collating your evidence and being systematic with your documents and policies
• Speaking to your staff and patient participation groups
• Reading Nigel Sparrow’s ‘Mythbusters’
• Being fully proactive in collecting and dealing with patient feedback
• Being open, honest and co-operative with inspection teams
• Asking for help when needed

What to Expect When You’re Inspected

• Inspection team size will be tailored to your surgery, and will comprise at least one GP and one inspector as well as perhaps a Practice Manager or Nurse, and an Expert by Experience
• Inspections use interviews with patients and staff as well as reviewing practice data and procedures
• Inspectors will collect and review comment cards that people have completed
• The inspection may involve speaking to other providers you work with, like care homes
• At the beginning of the inspection, your inspectors will want you to explain to them what it is your practice does that’s outstanding and what you’ve done to improve patient outcomes and experience
• Do what you can to help the inspection team find the evidence that your service is safe, effective, caring, responsive and well-led
• Bring to the fore all examples of good and outstanding practice
• After the inspection visit, your inspection team will hold a feedback session with you to share initial thoughts and findings. You will later be sent a draft inspection report and given the chance to challenge any inaccuracies you find
• Final outcomes are published to the CQC website
• Once your area has been fully inspected, inspectors will meet with the CCG and NHS Area Teams to explore trends and action plans, and celebrate outstanding practice too.

Good luck to all GP surgeries as we enter this new period of inspections. Don’t forget to share your experiences of CQC inspections here, for the benefit of your fellow Practice Managers.