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An inspector calls: listening to CQC suggestions

An inspector calls: listening to CQC suggestionsNow that a healthy number of GP practices have enjoyed the pleasures of a 2015 CQC inspection, we thought it would be a good time to take stock of some of the key trends that inspectors are repeatedly talking about – both good and bad.

The CQC’s inspection reports always highlight successful examples of excellent working and areas that can be improved, whatever the overall rating.

The positive trends

Wading through recent reports, practices average at least one area of outstanding work, while some actually achieve three or even four. The most common areas of outstanding practice are:

  • Effective multidisciplinary team working
  • Access
  • Identifying and meeting the clinical needs of patients
  • Responding to the needs of the population
  • Clinical care
  • Leadership and management

Excellent examples of multidisciplinary working demonstrated strong links with secondary care teams, community nurses, and third sector organisations with weekly multidisciplinary team meetings held in the practice to discuss these complex or vulnerable patients. Other practices demonstrated strong partnership working with other local GP practices, out of hours services, and local councils for different groups of patients.

Many examples of outstanding practice stemmed from the practice’s understanding of its patients’ needs. Some surgeries offered services to proactively manage patients at risk of developing long-term conditions such as diabetes by using risk stratification software. Others offered additional services to meet the needs of certain population groups such as the homeless or students.

When it comes to access, examples of effective online or telephone appointment booking systems were noted, as was a range of innovative approaches to efficiently use the scare resource of home visits.

Suggested improvements

However good a practice is, it’s common for inspectors to identify areas where a practice could improve its patient care or governance processes, with an average of three areas for improvement noted per practice. The most common areas for improvement are:

  • Safety culture
  • Recruitment and staff management
  • Responding to the patient population
  • Medicines management
  • Staff training
  • Audits
  • Infection control
  • Complaints

Examples of improvement

Taking into account those areas listed above, what can practices do to improve? Here are ten suggestions from recent reports:

  • Ensure clinical staff receive safeguarding children refresher training appropriate to their role.
  • Ensure that the practice maintains appropriate recruitment records and introduce systems to verify staff registration with their appropriate professional bodies.
  • Provide all nurses with Disclosure and Barring Service (DBS) checks and administration staff undertaking chaperone duties.
  • Clinical audits were instigated from within the practice or as part of the practice’s engagement with local audits. However the completion of these audits was more focused on the individual professional development of clinicians and the provider should develop clinical audit further to enhance their existing systems to improve patient care and outcomes.
  • The practice policies and information for staff which are held on computers should have a clear indexing or version control system to ensure staff can find the most up to date policy.
  • The practice whistleblowing policy covered how to raise concerns internally and should include how to raise a concern externally and how the whistle blower is protected by law.
  • Ensure that patient’s written consent is obtained before specific treatments and clinical interventions are carried out.
  • Ensure the policy and procedure for safety of GPs bags is carried out including the checks on the medical equipment calibration and the processes for checking in and the checking out of prescriptions pads and medicines.
  • Improve the security of access to emergency medicines and the documentation of the amount of emergency medicine held in stock.
  • Ensure monitoring checks for health and safety and the environment are documented.

To read through the reports head along to the CQC page here. You can filter the reports by date on the left hand side. To see the most recent, click “Last inspection date”, then “This week”.

Have you been handed a list of suggested improvements by inspectors? Did they or could they make a difference? What’s the best suggestion you’ve seen? Let us know by commenting below or in the forum

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Practice Index

We are a dedicated team delivering news and free services to GP Practice Managers across the UK.

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