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Steve Field's column

  • Organisations we regulate

In this month’s column, I talk about an emerging area of focus for CQC, GPs working at scale and look at an outstanding practice in London. I also want to use this opportunity to update you all on our next phase of regulation for general practice.

Regulating general practices working at scale

The pace and scale of GP practices collaborating together and with other healthcare providers has increased. The level of this collaboration can take a number of forms, ranging from informal collaborations and networks through to formal mergers of partnerships. As a regulator, we need to be in tune with these developments and adapt our approach where necessary.

We are currently undertaking work to assess what our regulatory approach should be to these different types of providers. An early theme from this work is that although not all primary care at scale models will require a change of approach to regulation, strong relationship management, at the right level, is central to ensuring that we work as effectively as possible. Our task now is to develop a set of characteristics to identify providers where we will take an amended approach.

During 2018/19 we will inspect 20 large scale primary care provider organisations and use the learning to evolve our approach. As well as working with these providers, we will also work with the public to ensure that our approach continues to be clearly understood and reflects what matters to them. I will continue to keep you updated through the bulletin and in this column on any developments to our approach.

Next phase update for general practices

As part of our new approach to regulation we have been working to design a system of provider information collection (PIC) for practices rated good or outstanding. Its purpose is to help monitor changes in the quality of care and provide additional context to the information available we already hold about a practice gathered from stakeholders and national data. This work is increasingly important following the introduction of intervals of up to five years between inspections for good and outstanding practices.

Following a review of progress on the PIC and the associated annual regulatory review (ARR) process we have decided that more time is needed to test the end-to-end process before it goes live. This will enable us to ensure that there is sufficient time for inspectors and practices together to test the whole process and the digital solution is right. Our decision means that the new collection exercise will launch in April 2019

We have worked with partners on the Regulation of General Practice Programme Board to ensure that the data we collect through the PIC is not being collected anywhere else in the system. We will continue to engage with practices and their representative bodies to improve and refine how the process will work.

Our timescale for implementation recognises the pressure on practices over the winter and our commitment to reduce workload associated with regulation, as well as not introducing a new approach before it is fully ready for both inspectors and practices.

Visiting outstanding practices

One of my favourite elements of the job is getting the opportunity to go out and visit outstanding practices and see the work they are doing to deliver truly great care to their patients.

This month I visited Woodgrange Medical Centre. This is one of the few practices rated as outstanding in London and provides absolutely brilliant care for nearly 14,000 patients in a deprived part of the capital. For a number of years now the practice has delivered outstanding results for a number of long term conditions, particularly diabetes. That the practice can deliver high quality care in the challenging environment in which it works is testament to the leadership and the hard work of the whole practice team there.

While I like to shine a light on the inspirational work of the outstanding practices that I get to visit each month, it’s also important to share the successes of practices that have been on an improvement journey. In June we will publish the latest in our series of ‘Driving improvement’ reports, this time looking at general practices who have improved their rating. Through a series of 10 case studies, we shine a light on the hard work the practices put in, and examine in more detail the reasons behind that improvement. Keep a look out in next month’s bulletin.

Have a great month everyone.


Last updated:
08 June 2018