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Secret Diary : What the CQC changes mean for Practices like mine

The Care Quality Commission (CQC) have announced that they are launching a consultation on proposed changes, for a more flexible and responsive regulation. I am sure that there are those amongst us that would like to see the whole CQC scrapped. However, I am not one of them, and I do think we benefit from some regulation, but would like a lighter approach.

Once we get the phone call for an inspection, we all panic – which, I suppose, is only natural.   The impression that we have on a visit is that the inspectors are looking for issues rather than it is a checking and supporting process. No two surgeries are run the same way, nor do we have the same cohorts as others – we have to adapt the running of the practice to the patient base we have. So why do all inspections follow the same course?

I agree that there has to be concerns when surgeries are marked up as “inadequate” or requires improvement” but many practices fall into the category of “Good” or “Outstanding”. We have only had one visited inspection and to be frank, I found the whole thing scary. After having sent masses of information to them beforehand, the team of three descended on the surgery for what felt like military procedures.

We were told what they could do, and what may happen, but having someone coming in and saying they can go and rifle through your drawers at will and have access to everything is scary. It was a full 10 hours they were here, incredibly stressful and felt more like they were determined to find issues and they would delve until they found something.

Our second inspection was handled over the telephone which was a far better experience for us. We were able to have a team approach to what they asked for, instead of being taken away one by one to be grilled. It was a far friendlier approach, and the inspector could get a good feel for the surgery from the way the team answered the questions. This was far shorter - about 2 hours - and a far better way of looking at how we provide a service.


The shape of future inspections to come…

So, what would I like to see change?  The CQC can automatically get a feel for a surgery, by looking at QOF results, CCG reports, Child Vaccinations, Flu numbers, reviews on various websites and, complaints amongst various other things.

The views must be taken seriously though, and one bad patient review should not be deemed the norm.  Nor one glowing report be an indication of quality.

There will be times when a visit maybe necessary and in those cases a list of some of the issues given to the practice before the meeting would be useful for investigation.

As to the current rating system, I am not sure that the public are aware of this and in some cases may only have one option to join the practice.

As for practices they are anxious to get as higher rating as possible as its kudos to have OUTSTANDING I am sure.

I wonder whether the CQC have thought about Primary Care Networks, as we are working more closely with local practices, we are somewhat dependent on us all running an excellent service.

In our PCN we are all graded the same, which is reassuring.

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