Just when you think you’ve got the CQC inspections sussed, and you’ve successfully survived your first visit, along come some changes to the regulations! Yes, that’s right – later this year the CQC will be changing the focus of its inspections.
Originally scheduled to come into force in October 2017 – but delayed by the general election – changes will now take place in November 2017 and the majority of changes revolve around the key lines of enquiry (KLOEs) and prompts for inspectors, standardising inspections across healthcare and simplify the process for organisations that provide more than one type of service.
The changes to KLOEs and prompts are the result of feedback following the CQC’s Next Phase consultation. It has merged previous versions, added new content to strengthen specific areas and reflect current practice, and made some changes to the wording to improve and simplify the language used. The changes have also been designed to shift inspections away from what some people consider to be a ‘box-ticking’ exercise – and create a system that focuses on improving service delivery. This will take the form of:
A focus on failing practices – Providers rated as good or outstanding overall, the CQC will move to an inspection interval of up to five years. Providers with an overall rating of inadequate will be inspected every six months and those rated as requires improvement every 12 months, until they improve.
Monitoring of high-risk care providers – Tighter monitoring and increased frequency of unannounced inspections will be the order of the day.
Data and information – Greater emphasis will be placed on using patient, inspection and partner data to improve care. This will also help care to be provided to different population groups.
What does it mean for practices?
In a nutshell, there will be a lot of changes – some more major than others. In fact, if you include all additions, amends and deletions to KLOEs and prompts, there are 122 changes in total. You can view the updated assessment framework and changes here.
The CQC has also simplified its assessment frameworks – the 11 separate frameworks for healthcare services have been merged into one, and the two frameworks for adult social care have also been merged into one.
Some of the key themes to look out for – areas in which the new KLOEs focus – include:
- End of life care
- System leadership, integration and information-sharing
- Medicine management
- Information governance and data security
- Technology usage to boost efficiency, accessibility and more person-centred
- Personalisation, social action and the use of volunteers
Commenting on the new inspection content, the CQC says: “Safety continued to be our biggest concern across all sectors – often influenced by the quality of leadership.” Add into the mix the desire by the CQC to see ongoing improvement and it means inspectors will focus on:
Safety – The CQC has used the learning from its inspections to strengthen a number of elements of safety, including recruitment practices, safeguarding, discrimination, medicines management, information sharing and management, and responding to external alerts and reviews.
Leadership – In strengthening its assessment of well-led, the CQC is clear that there is a demonstrable link between leadership, culture and the delivery of safe, high-quality care, and therefore its focus on well-led is intended to support and reinforce this link.
Continuous improvement – Practices will be expected to show continuous improvement. Inspectors will want practices to demonstrate “how they are developing and adapting to new evidence of good practice as well as the changing care landscape to improve the quality of that care”.
Annual reporting?
As part of the new plans, GP practices will most likely be expected to provide information to the CQC every year on how they plan to improve the quality of care. It’s worth pointing out here that consultations are still ongoing and this element is still up for discussion.
The regulator’s consultation document on the next stage for inspections says that the annual information gathering will replace the current system, where GPs have to provide evidence for every inspection.
Under the new regime, practices will need to provide annual evidence on what changes have occurred in the past year affecting their quality of care, with examples of good practice and ‘effective and responsive care to each of the population groups’.
The consultation document says: “We will replace the existing provider information return with an annual online information collection. We will ask providers for information every year rather than as part of the preparation for an inspection, and will encourage them to keep it up to date.
“This is one way that providers can demonstrate an open culture and that they are taking responsibility for assuring the quality of care they provide.”
It says that examples of the information they will be collecting include:
- What has changed about the quality of care provided over the last year and what plans they have to improve;
- Examples of good practice; and
- How they provide effective and responsive care to each of the population groups.
All-in-all, there are many, many changes taking place to inspections later this year – many of them subtle, some more important and wide-reaching. It’s a topic we’ll continue to cover between now and November – watch this space!
What do you think of the new inspections? Let us know by commenting below or take in the Practice Index Forum here.
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