The CQC is currently consulting on their inspection process and how they rate providers. The main points from our response are summarised here:
- Developing different assessment frameworks for each sector, including general practice, would be beneficial. It would also be a positive step to have inspection teams made up of people with experience of the day-to-day running of a GP practice.
- It would help to take into account the local context a practice is working in, such as hospital capacity, decommissioning of local services and cuts to community services.
- More clear and detailed guidance should be published to aid compliance and evidence tables should be reintroduced, so it is clear to practices what steps they need to take to remedy any areas the CQC is not satisfied with.
- Practices should have the option of providing pre-submitted examples of how they meet the required standards they are being inspected on, rather than having to have evidence ready to cover all areas on the day of inspection. This would reduce the current excessive burden of preparing for CQC visits.
- A more focussed approach on a selection of specific areas would also make the process more proportionate.
- Re-inspection of practices who need to demonstrate improvements takes too long and reports are produced too slowly. Cuts to the inspection workforce and a lack of a process for picking up the work of inspectors who are signed-off sick are significant factors in this.
- Workforce shortages also see inspections cancelled at short notice, with the large amount of practice time committed to the preparatory work going to waste.
- Where inspectors forget to ask for a specific piece of evidence this should not be logged as the practice being unable to demonstrate that they are compliant, in most case a brief follow-up to ask for the document would resolve the issue.
- The process to challenge inaccuracies in reports needs to be simpler and broader, such as asking for context to be given to statements and the option to challenge generalisations.
- Repeating the same findings throughout the report can them appear worse than they are to patients. An adverse finding should just be included once in the relevant section.
- External data sources such as patient satisfaction should only be used when up-to-date and different sources should be equally weighted.