CQC could shift focus from GP practice inspections to system-wide view

The CQC is considering a 'radical shift' that could see inspections of providers such as GP practices 'reduced' in favour of assessing how care is provided to different patient groups throughout the whole healthcare system in their local area.

CQC chief executive David Behan

The watchdog will consult in January on changes to its regulation strategy for 2016-2021 after all practices and other healthcare providers have undergone inspection.

A CQC consultation runs until 22 November on potential reforms outlined in the Building on Strong Foundations report released by the watchdog on Wednesday.

The CQC is looking to expand its reach to include assessing the quality of care for 'specific populations and across local areas', which could include greater emphasis on how well providers are working in partnership to provide patient care in addition to being inspected individually.

But it adds that it 'does not have the resources to do everything we would like to do' and 'there is the potential' for a radical shift in the long term which would 'involve reducing some aspects of comprehensive provider assessment' once all services have been inspected - and placing a greater emphasis on following a patient's experiences throughout the whole healthcare system.

Map: CQC GP ratings

The CQC said: 'This approach could improve information about the quality of care that groups, such as older people, experience as they move between different services, but could also lead to a corresponding reduction in information about individual providers, meaning people might have less up-to-date information to help them choose services.

'The more we shift in this direction the more we will need to redirect resources away from our existing provider-based approach.'

The last time CQC overhauled its regulatory approach - in October last year - it implemented the current four-point rating system, created a special measures programme for struggling providers and put a stronger emphasis on using data to inform inspections with the launch of its intelligent monitoring scheme.

The consultation on its new five-year strategy will also take into account ‘what CQC has learnt’ over the last year under its current approach and look to see how inspections can better fit with the developing ‘new models of care’ – which could see boundaries between primary, community, hospital and social care become less distinct.

CQC inspection overhaul

It will explore how the CQC can become more efficient by streamlining lower-risk applications and changes to registration, how it can use data for smarter monitoring and how it can tailor inspections to services. The watchdog has already told GPonline that it will inspect practices found to be ‘outstanding’ or ‘good’ less frequently than other services.

David Behan, chief executive of the CQC, said: ‘Our last strategy created a more rigorous inspection approach that gives providers and the people who use services a deeper insight into the quality and safety of care. This is crucial to help people using services make informed choices and so that providers know where they need to improve.

‘Our next strategy will set out the case for developing our approach – building on the strong foundations we now have in place.

‘Since April, we have engaged over 700 members of staff and stakeholders about the future direction of regulation. We will make our current model more efficient and effective by being more risk-based and proportionate; we will also look at the quality of care in a geographical area and across pathways of care.’

Click here to take part in the CQC consultation

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