You are here
What we will inspect: types of inspection (GP practices)
Our approach to inspection activity from April 2021
Throughout the pandemic, our regulatory role has not changed. Our core purpose is to make sure the public receive safe, effective, compassionate and high-quality care. This has remained at the centre of our activities and will continue.
Our inspection activity from April is a continuation of our inspection programme. The way we inspect GP locations has not significantly changed.
We’ll spend less time on site as part of our inspection activity and we will work with GP practices to gather evidence in different ways. For example:
- interviewing practice staff using online video calls
- asking practices to share links to our Give Feedback on Care form and ‘Because we all care’ campaign to encourage patient feedback
- GP specialist advisors accessing clinical records systems digitally, which means they don’t always need to be on site. See GP mythbuster 12: Accessing medical records during inspections. We encourage practices to look at the search areas ahead of inspection.
As well as continuing to respond to risk, we will start to:
- re-inspect locations with:
- breaches of a regulation(s)
- no breaches, but rated as requires improvement overall
- inspect services registered for over 12 months but have not yet been inspected.
Practices rated as inadequate overall or in special measures and newly-registered services
For these practices, we will carry out:
- comprehensive inspections of all five key questions
- clinical systems searches and associated clinical records reviews (conducted off-site where possible)
Practices rated as requires improvement overall
For these practices we will use an extended version of the focused inspection approach used for services rated good or outstanding. This will help us to identify improvement or deterioration.
- These inspections will cover the safe, effective and well-led key questions (as a minimum). They will also cover any other areas required including:
- key questions with breaches of a regulation
- key questions rated as requires improvement or inadequate.
- Following inspection, we may update overall ratings. We will carry forward ratings from previous inspection activity for key questions that are not inspected. This is in line with our approach for good and outstanding practices.
- We will carry out clinical systems searches and associated clinical records reviews for all. They will be off-site where possible.
Practices rated as good with a breach of regulation
- Practices rated as good with a breach of a regulation for one key question will be followed up without a site visit where possible.
- If we do not carry out a site visit, we cannot update the overall rating. We can only change ratings for a key question or a population group.
Focused inspections enable us to follow up any potential changes in the quality of care that our monitoring activity has highlighted. These inspections only focus on certain key questions to explore particular aspects of care.
We will carry out more focused inspections for providers rated as good and outstanding overall: this means we will not always consider all five key questions on each inspection.
However, we will always inspect the effective and well-led key questions as a minimum. In some inspections, we may also inspect the safe, caring and/or responsive key questions if the information we have suggests that the quality of care has changed since the previous inspection. When we announce the inspection we will tell you what the focus of the inspection will be. We may change that focus if additional risks emerge during the inspection.
Focused inspections can change an overall rating at any time, using key question ratings from the focused inspection as well as the remaining key question ratings from the last comprehensive inspection.
In some circumstances, we may carry out a comprehensive inspection of a practice rated as good or outstanding. We may do this, for example, where significant concerns arise or there have been significant changes to the quality of care provided.
Comprehensive inspections address all five key questions, and ask is the service safe, effective, caring, responsive and well-led? We will always carry out a comprehensive inspection of services that we have not yet inspected, or if a service has an overall rating of inadequate or requires improvement.
A comprehensive inspection for general practices includes all six population groups.
We will inspect when we need to follow up on an area of concern. This could be a concern identified during an inspection that has resulted in enforcement action, or concerns that the public, staff or other stakeholders have raised with us.
These inspections do not usually look at all five key questions. They usually focus only on specific areas indicated by the information that triggers the inspection. Follow up inspections may be unannounced.
Inspecting GP practices who are working at scale
We recognise that many GP practices are collaborating with other organisations in formal and informal ways. We are developing and testing our approach to inspecting to make sure services provide high-quality care, and that leadership and governance at all levels support this. Our strengthened relationship management and monitoring will help us to understand where collaboration is happening and how this will affect what we inspect. We will reflect any collaborative working in your inspection report.
If your practice is rated as good or outstanding, we will ask you for some contextual information about your links to other practices, federations or networks when we arrange the telephone call to carry out the provider information collection.
Inspecting complex providers
If you deliver services across more than one sector, we try to align our inspections to be more efficient and to make the process simpler for you. For example, some organisations may provide a combination of primary health care services, acute hospital services, mental health care, community health services and ambulance services, and may also run care homes. We will use teams of specialists to inspect each of these services. Also see how we rate services.
- Last updated:
- 10 May 2021