‘OK,’ I say. ‘That’s fine. We have known for years this day would come and prepared accordingly. We are ready, we’ll be fine!’ I wave my hand reassuringly in his general direction.
We look at the email and discover that there is some work to be done. Documents, audits plus a variety of other evidence covering what we do has to be submitted. The inspector will also give us a call to make sure the notification has been received and to tell me a bit more about inspection day.
I receive the call the following day as well as a pack containing patient feedback cards and a poster announcing the visit and inviting patients to speak to the inspector on the day. The poster is duly displayed and patients encouraged to complete the cards.
An email confirming the arrangements drops into my inbox, which includes a timetable and a list of documents we need to have ready on the day – it appears we are good to go.
The documents are scrambled from a variety of folders and we use this as an opportunity to consolidate all of these into an all-in-one-place system on the practice intranet. More searches are run and the news announced to everyone in the practice.
Having clicked ‘send’ on the announcing email I await my colleagues’ reaction – alas, nothing! I wait a little longer but the news does not seem to stir anyone. Walking through the admin office I enquire is everyone OK?
Everyone is OK, in fact, smiling and nodding. Someone says ‘you prepared us for this, we are fine!’
The LMC is also contacted to attend on the day as an independent observer.
I have always been fascinated by this CQC concept, an amalgamation of three former commissions to regulate care services in England. Now it’s general practice’s turn.
General practice already submits data to NHS England, its CCGs, is randomly checked by Healthwatch and other patient organisations and any training practice will have experienced some kind of scrutiny to ensure all is well (this list is not exhaustive).
Does general practice really need a regulatory body sending inspectors into every practice? Has anyone ever produced a Cost Benefit Analysis for this?
Nevertheless, I embrace the idea and decide to work with it as I am curious where it will take not only the practice but also me professionally.
For three years I attend events, read emailed documentation describing the inspection process and peruse the CQC website.
Staff awareness is raised, they are trained and updated to their eye balls. We tighten how we recruit, what documentation we ask for and how we record it. We risk-assess down to our practice biscuit policy and plaster the walls in the patient waiting rooms with appropriate information to encourage patients to self care and feedback to us how they are getting on with this and our service whilst, at the same time, telling them how well trained we are.
Getting ready for inspection
Looking around the surgery, I realise perhaps it is time to have a little clear out and order a skip. The plants in the waiting room are polished to an inch of their lives, a variety of internal checks are undertaken and the cleaners motivated to work, perhaps a little harder, towards the big day.
The inspectors would like to sit down with us first to hear about the practice so we set about creating a presentation that highlights what we do well – not only to the inspectors but, almost more importantly, to us. We have a lot to say, so inspectors hang on to your hats!
A neighbouring practice has their inspection on the same day and the practice manager there and I exchange ‘wish you well’ via email.
The reception manager pops her head through my door ‘Our visitors are here’. It is time to show what we do well and what we are capable of achieving when applying our well-established team ethos. The practice is ready, the stage set, it is 8.45am, time to dance and shine, right through to 5.30pm - large Guinness anyone?
(PS: The practice received a full-house of the CQC rating ‘good’ with four areas of outstanding work mentioned in the report).
- Heike Burnett is a practice manager in East Grinstead, West Sussex