A new assessment programme from the CQC started in March 2026 and will target so-called "lower risk practice" who are good or outstanding and were last inspected between 2017 and 2022. FPM explains how this works.

Returning to Good and Outstanding: What Primary Care Teams Need to Know

Quick‑read

The Care Quality Commission (CQC) began its Returning to Good and Outstanding project in March 2026. It targets GP practices rated Good or Outstanding that haven’t been inspected for several years and are considered lower risk. The aim is to increase the volume and consistency of assessments while ensuring that long‑unvisited services still meet expected standards. Practices receive at least five working days’ notice and a site visit focusing on 10 non‑clinical quality statements across the five key CQC domains: Safe, Effective, Caring, Responsive and Well‑Led. GP Specialist Advisors are not routinely involved unless concerns arise. The project runs alongside usual CQC activity and is intended to strengthen assurance, increase contact with providers and support safe, high‑quality care.

Why this project matters now

CQC has been clear that two of its priorities in primary and community care are:

• increasing the volume, quality and consistency of inspections, and
• streamlining systems so they remain fit for purpose for patients, the public and providers.

Many GP practices last received a full inspection several years ago, particularly those with strong ratings and no regulatory concerns. The new project aims to close that gap by re‑engaging with these services in a proportionate, focused way.

Which practices are included in this category?

The project targets NHS GP practices that meet all of the following criteria:

• currently rated Good or Outstanding
• last published inspection report between 2017 and 2022
• considered lower risk
• have no ongoing regulatory activity and are not dormant

This means the programme is not about identifying failing services but about ensuring that previously high‑performing practices continue to meet expectations.

What the assessments involve

Assessments under this project follow CQC’s established methodology but with a tighter focus. Key features include:

• A site visit
• At least five working days’ notice
• A review of 10 non‑clinical quality statements
• No routine involvement of a GP Specialist Advisor unless concerns emerge or a positive escalation is needed

This approach allows CQC to reserve clinical expertise for situations where it is most needed, while still maintaining robust oversight.

The 10 non‑clinical quality statements

The quality statements span the five familiar CQC domains. According to the CQC’s published details, they include:

Safe

• Safe environments
• Safe and effective staffing
• Infection prevention and control

Effective

• Supporting people to live healthier lives
• Monitoring and improving outcomes

Caring

• Kindness, compassion and dignity

Responsive

• Equity in access
• Equity in experience and outcomes

Well‑Led

• Shared direction and culture
• Governance, management and sustainability

These statements reflect the non‑clinical foundations of high‑quality general practice: leadership, culture, safe systems, and equitable access.

What happens if concerns are identified?

If an assessment raises issues, CQC may escalate to a full inspection, this time involving GP Specialist Advisors. This ensures that any clinical or operational concerns are reviewed with appropriate expertise.

How this fits with wider CQC changes

The project runs alongside CQC’s usual assessment activity and sits within a broader shift back toward sector‑specific assessment frameworks. Draft frameworks published in 2026 propose the reintroduction of Key Lines of Enquiry (KLOEs) and numerical scoring, while retaining the five key questions and single‑word ratings. See our article here for more on this and the consultation on it. CQC has emphasised that clinical leadership remains central to its approach, with new Chief Inspectors appointed for each sector.

What this means for GP practices

For practices, the project offers:

• an opportunity to demonstrate continued quality
• a predictable, proportionate assessment process
• early notice and a clear focus on non‑clinical standards
• reassurance that clinical scrutiny will be applied only when necessary

For patients and the public, the project aims to strengthen confidence that even long‑uninspected services remain safe and effective.

Returning to Good and Outstanding is not about catching practices out; it is about re‑establishing regular contact, refreshing assurance and supporting the sector to maintain high standards. As the CQC puts it, everyone has the right to safe, high‑quality care, and this programme is one way of ensuring that right is upheld.

Let Us Help You Prepare: 

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