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The inspector is on the blower!

by in CQC, GP Practice Management

Warning! It’s now time to reset the answerphone message from “I’m out of the office indefinitely” to a more welcoming and possibly more professional version. Why? Well, the CQC is coming to a telephone near you!

No need for mass hysteria, but the brow does become slightly wrinkled when we ponder what our colleagues at the CQC might be asking for. For those who don’t know what I’m on about, I’d suggest having a look at Dr Benneyworth’s (Primary Medical Services Chief Inspector at the CQC) blog. If you haven’t read it, I suggest you should.

Let’s start on a positive note. Good news! The CQC recognises the hard work undertaken in primary care of late in our fight against coronavirus. However, the purpose of the CQC still remains, and Dr Benneyworth has advised that they’ll need to embark on a series of phone calls to us which will start on Monday 18th May 2020.

The plan

The mission is to gauge what specific actions have already been completed by us, with regard to the management of COVID-19, but also to find out what the current issues are and how they’re to be tackled. The Dr Benneyworth’s blog states that this process is designed to be a supportive one that ‘captures and shares any concerns’.

Having a watchful eye – akin to that on Mount Doom in The Lord of the Rings – it’s also understood that those practices where concerns have been raised should expect to be contacted first. These concerns would be the culmination of intelligence gathered from the public, care staff and/or whistleblowers during this crisis.

Practices are to be asked questions in four areas, and all the information gleaned will be added to something called the Emergency Support Framework. For each area, the inspector will ‘informally explore’ and discuss matters with you. Whilst the discussion will mostly focus on how prepared you are and how your service is managing in this pandemic, the CQC will also discuss with you whether there’s anything else you need. If you do need any additional support, the inspector will point you in the right direction, or share examples of how other practices are coping.

All in all, this sounds positive!

Whilst I’m unsure what answers will be expected, I’ve listed my thoughts below, coupled with what’s available on Practice Index PLUS. Of course, this is a snapshot, and my viewpoint, and as soon as more information is known, we at Practice Index will update you further.

  1. Safe care and treatment
  • What measures are you putting in place to reach out to the whole community, such as e-consultations, F2F appointments, telephone calls, etc?
  • How are you communicating with your patient groups?
  • Do you have an appropriate number of appointments to manage your needs?
  • How are you managing all of your core services?
  • Do you use social media to promote the services you’re offering?
  • Prescription planning – in particular, repeats for those who are vulnerable. Have you any assistance to support delivery, or could you utilise the NHS Volunteer Army or other supporting groups? The Prescribing policy [PLUS] can help provide the guidance on the areas you need to cover.
  • Pandemic management planning – you can refer to the Pandemic management policy [PLUS] for a thorough plan.
  • The route through the practice: Are patients able to remain safe? Is there a plan?
  • PPE arrangements for all. Have you got enough and is the supply chain working for resupply?
  1. Staffing arrangements
  • What are you doing to ensure there are appropriate staffing rotas in place?
  • Management of sickness, childcare issues, holidays: In short, do you have a plan or policy to support your needs? The Pandemic staffing policy [PLUS] can help you plan out your rota management.
  • Have you conducted individual risk assessments for staff? The risk assessment toolkit [PLUS] may be useful to record individual risk
  • Can staff work from home? The following policies may assist in demonstrating who works from home and how they are managed:

Audio-Visual Recording Policy [PLUS]
Homeworking Policy [PLUS]
Remote access to IT systems [PLUS]

  • Are the staff wearing scrubs and, if so, how do you keep these clean
  • Anything new to protect all – such as screens, additional hand gels, signage
  • How do you communicate with your teams and do they receive the daily NHS E / CCG updates?
  • Are your teams aware of any planned changes?
  1. Protection from abuse
  • Is there an awareness programme for the patients and has this been well publicised and, if so, where – social media, website, practice answerphone on-hold message? Are these messages all up to date, as this could reduce frustration?
  • Domestic abuse is well documented as having increased during the lockdown. Have you any links to support on your website, posters within the practice, or on an outward-facing window / front door of the practice / toilets?
  1. Assurance processes, monitoring and risk management
  • Do you have a COVID-19 Incident Log? The COVID-19 toolkit [FREE] can record all your cases in one place if you need a simple system.
  • Do you have a strategy, and are all of the team aware of it?
  • Meetings: How are all of the team aware of and involved in the plan, including those who are absent?
  • Have you put together a risk assessment, and were staff members asked for their views?
  • What about clinical governance matters, including SEAs and audits? Anything new for COVID-19? See the Clinical Governance policy [PLUS] for further advice.
  • Are the team members involved in order to support with change management?
  • Are you discussing any service delivery changes with your PPG?

Ducks in a row?

Of course, whilst the CQC has stressed that this doesn’t form part of the inspection process, rating or report, all information, undoubtedly, will be popped into that big box-file marked ‘Your Practice’ then dusted off the next time it comes round to inspection time.

As such, I’d suggest you need all those little ducks in a row!

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Mat Phillips

Mat Phillips

Mat Phillips is a Practice Manager and clinical governance specialist, facilitator and trainer. A primary care career spanning 30+ years within the NHS, in the UK Oil and Gas Industry and Royal Navy. Mat now provides specialist consultancy support to Practice Index and the wider primary care community.

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