CQC plans to reduce number of key lines of enquiry it uses to inspect GPs

The CQC is planning to reduce the number of 'key lines of enquiry' it uses to assess practices as part of its overhaul of GP regulation.

Earlier this month the CQC launched a consultation on its plans for the next phase of GP regulation, which is due to be implemented in October this year.

The regulator is proposing a more collaborative approach to inspections, which would see good and outstanding practices submit data annually to the CQC in return for a reduction in the number of times they undergo on-site inspection.

However, at the Practice Managers Association annual conference in Manchester last week, CQC deputy chief inspector for PMS Alison Holbourn said the regulator was also ‘intending to streamline our processes and reduce the number of key lines of enquiry’.

‘We are intending to visit good and outstanding practices less often. We will focus our resources and take a risk-based approach,’ she added.

Key lines of enquiry are a series of questions that CQC inspection teams use to assess a practice both before and during a visit. The CQC says using key lines of enquiry helps it ensure it is consistent in what it looks at under each of the five key questions it uses to regulate services (is the service safe, effective, caring, responsive and well-led?).

There are currently 27 key lines of enquiry used in general practice, many of which have one or more sub-questions that inspectors will use to assess practices.

Celebrate primary care

Ms Holbourn said that the NHS should celebrate the fact that nine in 10 practices in England had been rated ‘good’ or ‘outstanding’ by the CQC, adding that it was the ‘highest-performing’ sector in the NHS.

‘This is the first time this country has had a quality inspection of all parts of our system. Having gone to about 7,400 practices and rated them all we now know just under 90% of all of general practices in England are either good or outstanding,’ Ms Holbourn said

‘This is certainly something to celebrate – it’s not what we find in other sectors. [General practice] is the highest-performing sector we have and it deals with nine out of 10 contacts for less than 9% of the budget. I personally think that’s worth celebrating. If we do nothing else in the CQC we shine light on that.’

She added that in the small number of practices that had been rated inadequate, the majority were beginning to improve.

‘Of those placed in special measures, 75% have, with significant support, turned round and are on an improvement trajectory we hope will be sustained.’

Ms Holbourn also said that the CQC was looking to streamline its registration processes for GP federations, collaborations and ‘at-scale’ providers and it would be testing its new processes in each region from October.

She said the regulator needed to be ‘more agile’ in how it responds to the complexities of registering these new organisations because ‘we are registering more and more of these groups’.

‘Around 75% of England is covered by a federation of one type or another or a large-scale or at-scale provider,’ Ms Holbourn said.

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