CQC overhauls its intelligent monitoring system after GP feedback

The CQC has 'refreshed' its intelligent monitoring scheme, which now highlights areas of 'variation for further inquiry' rather than implying 'risky' practice following feedback from GPs.

In a relaunch of intelligent monitoring – the system CQC uses to help organise and prioritise inspections – practices will be flagged for ‘large variation for further inquiry’ or ‘very large variation for further inquiry’ on individual aspects of care if their data is far removed from the average score.

GP intelligent monitoring is comprised of 33 indicators which pull in data from the QOF, patient survey, prescribing data and others. The new system will flag up separate indicators if they are far removed from the average across all practices.

Practices are given an overall ‘percentage score’ which adds up the number of ‘large variation’ flags a practice has.

The CQC says a flag for variation does not represent a cause for concern, just a line of inquiry to question – a step back from the old system which was accused of using pejorative language to suggest patients were being put at risk in practices with low data scores.

CQC intelligent monitoring

The first iteration of CQC’s now-infamous intelligent monitoring system stratified practices into ‘risk bands’ which it published online. These were widely interpreted to be pre-inspection ratings in the media and by patients.

It has since scrapped the priority banding system and apologised to every practice in England.

CQC is still publishing intelligent monitoring data online, which can now be found on the watchdog’s website, in the form of an individual report on each practice’s profile page. These are featured alongside the practice’s official inspection report once it has been visited and rated.

The tool will continue to inappropriately flag up practices with special circumstances that may cause some abnormal scores – such as university practices that cater for specialist populations – due to constraints of the current system, but it no longer suggests they are putting patients at risk.

The watchdog has previously said it is committed to becoming ‘more information- and data-driven’ in its regulatory approach.

But it has reiterated that its intelligent monitoring does not constitute a ‘judgement’ on practices, and the data will be used solely to help inspectors plan and schedule inspections. Other information, including tip offs from whistleblowers, the public and others can also influence how soon a practice may be visited by inspectors.

Map: CQC GP ratings

The indicators will be ‘refreshed’ on a twice-yearly cycle – meaning they will be updated with the most recently available data from the patient survey, NHS England and other sources.

CQC director of intelligence Emma Rourke said: 'We have improved the way we present our intelligent monitoring of general practices, following extensive work and discussions with our partners, including the RCGP, BMA, GPs, and the public. We have developed a new style of practice report and shared individual reports with every relevant practice for their comment on presentation and factual accuracy prior to going live on our website.

'We are committed to being open and transparent about how we work. By drawing on available national data and considering a range of indicators, intelligent monitoring informs when and how our teams undertake their inspections.

'We appreciate the help of those who have contributed to the development of our work and thank general practices for their responses during this verification process.'

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