The Wigton Group Medical Practice in Cumbria began preparing for its CQC inspection as soon as details of the new regime were announced early last year – 10 months ahead of its inspection in November.
‘We started to make small changes, such as putting disposable curtains in treatment rooms,’ practice manager Lin Baillie explains.
The semi-rural, eight-GP practice was among the first in Cumbria to undergo the new-style CQC visits. Ms Baillie says that while there were hopes for the best rating possible, the practice did not intentionally work towards achieving the ‘outstanding’ grade.
Realistically, she points out, no amount of short-term preparation can help you achieve the highest rating if the foundation and basics at the practice are not solid, something which takes years of commitment and hard work to achieve.
Wigton was rated ‘outstanding’ in three of the five inspection areas (being effective, caring, and well-led) and in all of the checks on the six patient groups. It was rated as ‘good’ in the areas of providing safe services and responsive services.
Ms Baillie attributes the practice’s achievement to the positive working environment at the practice, built on values such as team working, mutual respect and trust.
‘We have a can-do attitude and a stable workforce,’ she says. ‘Nobody is more important than anyone else, which can sound trite, but that is how it is here. Non-clinical staff are valued very much by clinical staff.
‘We work alongside all areas of the NHS, with community nurses, for example, and the third sector. Working relationships are strong. We are very much a part of the community.’
Preparing for inspection
Ahead of the inspection, the lead GP read up on CQC inspection reports and spoke to other practices that had been through the process.
Practice staff were involved in the process and meetings were held to keep them informed and allay any potential fears.
‘The inspection was one of the most stressful experiences of my working life,’ Ms Baillie admits.
‘Perhaps it was self-inflicted, because it was so important to us all that we didn’t sell ourselves short and did our best to demonstrate the excellent care and service that we believe we provide.
‘There has also been a lot of negative publicity around the process, so naturally staff had concerns. We held a session to make it clear what would happen, and who the inspectors would be talking to, and to reassure staff that they could be honest with the inspectors.’
The inspection itself went smoothly and the inspectors were professional and supportive, says Ms Baillie.
‘We had carefully read all the material sent to us to ensure we did what they asked, the inspectors had access to data required and they could speak to a wide range of staff. In our case, we included the cleaning staff.’
The practice put together a presentation, led by two of the GPs, to start the inspection. ‘This presentation is optional, but it set the tone of the day, so I felt it was useful,’ Ms Baillie explains. ‘We included patient feedback and invited a patient to attend. I and a member of the admin team also attended.
‘We talked about patient stories, highlighted why we offered a good service and showed them audit results demonstrating the effects of improvements we had made. Being able to show that we don’t just audit for its own sake was crucial.’
Advice for other practices
Ms Baillie has the following advice for other practices:
- Read all of the material the CQC sends ahead of the inspection thoroughly, so you are ready with the correct paperwork and can make available all of the people the inspectors need to speak to.
- Read reports from other practices to see what kinds of problems and weak spots are highlighted by the inspectors.
- Think about easy wins. Simple changes, such as investing in disposable curtains or vinyl chairs (rather than fabric) are ?easy to implement and will tick the right boxes.
- Maintain good record-keeping, but also ensure that you show how you act on the results of your audits and service monitoring.
- Involve patients in the process. Most are supportive – they will be keen to help and are usually your best advocate.
- Prepare your staff as much as you can and reassure them they are not alone in feeling anxious or nervous. There is no getting away from the fact that it is very stressful. The process involves non-stop questions. Prepare your staff for that and stay focused. Carry on doing your job as you would normally and answer any questions honestly.
- Remember, this is all about teamwork. To survive the inspection and come out of it successfully requires a whole team approach, it cannot rely on just one or two people.
Maintaining the practice’s outstanding rating will be a challenge for the future, Ms Baillie admits.
‘We need to maintain the culture we have created here, but we think we have robust enough systems in place to keep standards high,’ she says.
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