You are here

Ratings principles: primary medical services

Categories:
  • Organisations we regulate

Our inspection teams use a set of principles when rating services, locations and providers to ensure that we make consistent decisions.

The principles will normally apply but will be balanced by inspection teams using their professional judgement. Our ratings must be proportionate to all the available evidence and the specific facts and circumstances.

Reflecting enforcement action in our ratings

Where we are taking enforcement action we will reflect this in the ratings at the key question level.

  1. Where we have identified a breach of a regulation and we issue a Requirement Notice, the rating linked to the key question relevant to the breach will normally be limited to ‘requires improvement’ at best.
  2. Where we have identified a breach of a regulation and we take action under our enforcement powers, such as issuing a Warning Notice or imposing a condition of registration, the rating linked to the key question relevant to the breach will normally be ‘inadequate’.

Overarching aggregation principles

The following principles apply when we are aggregating ratings.

  1. The five key questions are all equally important and should be weighted equally when aggregating.
  2. The six population groups are all equally important and should be weighted equally.
  3. All ratings will be treated equally when aggregating unless one of the other principles below applies.

Aggregating ratings

There are too many combinations of ratings and the resulting aggregation to show here. However, we use the following principles as the basis of the aggregation and use our professional judgement to apply them to the specific combination of underlying ratings.

We will apply the principles in the tables below in the following situations:

  • When aggregating the effective and responsive key questions to an overall population group rating. When using the following principles the number of underlying ratings here will usually be two.
  • When aggregating the six population groups to an overall key question rating for the effective and responsive key questions. When using the following principles the number of underlying ratings here will usually be six.
  • When aggregating the five key questions to an overall service level. When using the following principles the number of underlying ratings here will usually be five.

There may be circumstances where we do not rate for one or more of these. For example, a GP practice at a university may not provide services to all six population groups. In these instances the number of underlying ratings may be fewer.

  1. The aggregated rating will normally be ‘outstanding’ where at least X number of the underlying ratings are ‘outstanding’ and the other underlying ratings are ‘good’.
Number of underlying ratings Number (X) of underlying outstanding ratings
1 – 3 1 or more
4 – 6 2 or more
  1. The aggregated rating will normally be limited to ‘requires improvement’ where at least X number of the underlying ratings are ‘requires improvement’.
Number of underlying ratings Number (X) of underlying requires improvement ratings
1 – 3 1 or more
4 – 6 2 or more
  1. The aggregated rating will normally be limited to ‘requires improvement’ at best where X number of the underlying ratings are ‘inadequate’.
  2. The aggregated rating will normally be limited to ‘inadequate’ where at least Y number of the underlying ratings are ‘inadequate’.
Number of underlying ratings Principle 8
Limited to requires improvement where there are (X) number of underlying inadequate ratings
Principle 9
Limited to inadequate where there are (Y) number of underlying inadequate ratings
1 – 3 Not applicable 1 or more
4 – 6 1 2 or more

When determining an overall rating for the effective and responsive key questions, we will also apply the following principle:

  1. For the effective and responsive key questions, the aggregated rating should closely align with the underlying population group ratings, plus an assessment of any practice level evidence.
Last updated:
27 March 2019