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What we do on an inspection

  • Public

Visiting services is an important part of our inspection process. It gives us an opportunity to talk to staff and people who use services.

Carrying out site visits also allows us to observe care and to look at people's records to see how their needs are managed.

Types of inspection

We carry out regular checks on health and social care services. We call these comprehensive inspections and we use them to make sure services are providing care that's safe, caring, effective, responsive to people's needs and well-led.

Some things – such as how frequently we inspect, the size of the inspection team we use and whether or not we tell the service that we're coming – depend on what type of service we are inspecting.

We also carry out focused inspections. These are smaller in scale than comprehensive inspections, although they follow a similar process.

We carry out focused inspections for two reasons:

  • To look at something we're concerned about, which might have been raised during a comprehensive inspection or through our monitoring work.
  • If there is a change in a care provider's circumstances. This might mean they've been involved in a takeover, a merger or an acquisition.

A focused inspection doesn't always look at all five of our key questions. The size of the team and who's involved depend on what the inspection is looking at.

Inspecting different types of service

There are some differences between the things we look at when we inspect different types of service. For example, when we inspect NHS trusts we look at eight core services. When we inspect GP practices, we look at how the practice provides services to particular population groups. We apply our five key questions to each of these things.

What are core services?

We don't inspect all the services that are provided by NHS trusts. There are eight services that we always inspect at every NHS acute hospital where they are provided.

  • Urgent and emergency services (A&E)
  • Medical care (including older people's care)
  • Surgery
  • Critical care
  • Maternity and gynaecology
  • Services for children and young people
  • End of life care
  • Outpatient services and diagnostic imaging (such as x-rays and scans)

What are population groups?

When we inspect NHS GP practices, as well as focusing on the five key questions, we always look at the quality of care for six groups of people:

  • Older people
  • People with long-term conditions
  • Families, children and young people
  • Working-age people (including those recently retired and students)
  • People whose circumstances may make them vulnerable
  • People experiencing poor mental health (including people with dementia)

By looking at services for these groups, we can make sure our inspections look at the outcomes of care provided for all people, including those who are particularly vulnerable. It also means we can present information about local services that are relevant to you.

We don't look at these population groups when we inspect GP out-of-hours services.

The start of the visit

At the start of the inspection, the inspector or inspection team usually meet senior staff. At this meeting, we will explain:

  • Who the inspection team are.
  • The scope and purpose of the inspection.
  • How we will communicate our findings.

Inspections of acute hospitals, GP practices and GP out-of-hours services begin with a presentation by the care provider, in which they give their own view of their performance.

Gathering evidence

The inspection team uses the key lines of enquiry and information from the planning stage to structure their visit and focus on areas of concern or areas where the service is performing particularly well. The team collects evidence against the key lines of enquiry by:

  • Gathering the views of people who use services. This includes:
    • Speaking to people individually and in groups.
    • Using comment cards placed in GP surgeries or busy areas in hospitals.
    • Staffing pop-up engagement stalls before NHS acute hospital trust inspections.
    • Using information gathered from complaints and concerns from people who use services.
  • Gathering information from staff.
  • Other inspection methods include:
    • Observing care.
    • Looking at individual care pathways.
    • Reviewing records.
    • Inspecting the places where people are cared for.
    • Looking at documents and policies.


At the end of the visit, the inspector or senior members of the inspection team hold a feedback meeting with senior staff. At this meeting, the inspection team:

  • Gives a summary of what has been found during the visit.
  • Highlights any issues that have come up.
  • Identifies any action the service provider needs to take immediately.
  • Outlines any plans for further announced visits.
  • Explains how we will make our judgements and publish them.
Last updated:
5 April 2016