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Nigel's surgery 97: Responding to coronavirus (COVID-19)

Categories:
  • Organisations we regulate,
  • GP and GP out-of-hours services

We understand that GP practices are facing unprecedented pressures and we are keen to support providers and the wider system.

Mandatory training during the coronavirus (COVID-19) pandemic

Although this is an exceptionally challenging time, it is still important care is safe and high quality. We have updated ‘Nigel's surgery 70: Mandatory training considerations in general practice’ to give guidance on staff training at present.

Keep in touch

In addition to usual notifications, we encourage you to stay in touch with us. Please contact us if you want to make us aware of specific concerns and issues or if you have any questions. This will help to:

  • enable us to understand the pressures providers are facing
  • support our ability to provide feedback to the health and social care system in line with our duty to provide an independent voice
  • help us support front line clinicians.

Notifications to CQC

There are no changes to the requirements to make notifications or the system used to make them. This may mean letting us know if your service is being negatively affected by coronavirus; it does not mean that you need to notify us of every single coronavirus related issue.

Here we set out examples of when a notification may or may not be necessary during the coronavirus outbreak. We will use information we receive via notifications to help to highlight service and system pressures.

The CQC (Registration) Regulations 2009 define which specific incidents, events and changes that affect a service or the people using it, we must be notified of. Most are in relation to changes to a providers’ registration status. You must also notify us about events such as of deaths which occur in some specific circumstances and some other incidents. Nigel’s surgery 21: Statutory notifications to CQC gives detailed advice on all notifications.

Notification of deaths

You do not need to notify us about every death of a registered patient.

GP providers must notify us if the death occurred whilst they were responsible for carrying on the regulated activity and were actually providing care. For example:

  • while a patient was in consultation with a healthcare professional
  • while at your health centre, practice or surgery
  • during a home visit

You must also notify us of deaths that occurred within two weeks of a clinical interaction with practice staff if the death:

  • was, or may have been, as a result of the care or how it was provided, and
  • could not be attributed to the course which the illness or medical condition would naturally have taken if the deceased had been receiving appropriate care and treatment.

(NHS Trusts must notify relevant deaths to the National Reporting and Learning System (NRLS) using their Local Risk Management System (LRMS) or the eForm on the NLRS website.)

We have updated our notification of deaths form so if you notify us of a death that meets the above criteria you can also tell us if it was caused by suspected or confirmed coronavirus. This extra information will help us to work with others to mobilise the right level of support and to inform the government response.

For very frail patients, where a decision has been made that they are managed in their home or a nursing/care home environment, there is no need to notify us if they die. It is important to keep a clear record of these consultations, including a record of capacity and any best interest decisions that are taken. Were the patient to die whilst in consultation with or receiving treatment from a healthcare professional this should still be notified in the normal way.

Case studies

Example 1

A frail elderly patient with multiple health conditions becomes infected with COVID-19. An appropriate best interest decision is made not to admit the patient to hospital, and this is clearly recorded in the patient record. The patient subsequently dies from the COVID-19 infection.

Is statutory notification to CQC required?

No. Given the higher mortality rates in this patient group this would be considered an expected death and no notification is required.

Example 2

A frail patient with multiple conditions becomes infected with COVID-19. A home visit by the GP is deemed necessary but this is not possible. (This could be due to a lack of PPE equipment as described in PHE guidance current at the time or a shortage of available staff.) The patient subsequently dies.

Is statutory notification to CQC required?

Yes. The practice was unable to provide care due to limitations caused by the coronavirus outbreak. Notification should be made to CQC to allow us to understand the pressures providers are facing locally. This will help us to develop a better understanding and national picture of system pressures.

Example 3

Practice A cannot continue to deliver services to patients due to staff illness and staff self-isolating in line with guidance. Practice A is part of a Primary Care Network (PCN) with four other practices in the local area. Services are being provided by the other practices in the PCN on behalf of practice A.

Is statutory notification to CQC required?

No. Temporary arrangements have been put in place for patients to ensure they have access to essential GP services.

If you are unsure whether to notify us of an incident, contact your inspector for advice.

How to make a notification

See our full list of notification forms. For each type of notification, there is:

  • an online form, you must use this if you have a CQC online account
  • a paper form to submit if you do not have an online account.

The ‘registered person’ must submit notifications. This is often the registered manager, but they can delegate the task to an appropriate staff member.

Further information

Information for GP providers about making statutory notifications is set out in:

‘Hot hubs/red sites’: registration applications and notifications

The requirements in different cases:

  • The provider is already registered to carry on the regulated activities of treatment of disease, disorder or injury (TDDI) and diagnostic and screening procedures from the location where the hot hub/red site is being set up.
    Where possible, the provider should briefly update their statement of purpose and notify us of this change, although we understand this will not be the immediate priority for providers at present.
  • A provider is hosting a hot hub/red site on behalf of a Primary Care Network or a group of practices.
    The host provider should briefly update their statement of purpose and submit the notification to us. Again, we recognise that this process may take a little longer than it usually would in light of current circumstances.
  • An existing provider is setting up a hot hub/red site from a new location (eg a marquee, football stadium etc).
    The provider should submit an application to vary their registration.  Please mark the application COVID-19 to speed up the registration process.
Last updated:
13 May 2020