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Monitoring questions for independent doctors and clinics (including online services)

Categories:
  • Organisations we regulate

During the monitoring call our inspector will focus on these specific key lines of enquiry. You can open the questions to see the type of detail they will be interested in.

Safe

S1: How do systems, processes and practices keep people safe and safeguarded from abuse?
  • How do you ensure staff recognise safeguarding issues for adults, children and other vulnerable people, and that they take appropriate action?
  • How do you ensure that the management of any safeguarding concerns does not discriminate people, and that their human rights are protected?
  • What are your arrangements to respond to medical emergencies?
S2: How are risks to people assessed, and their safety monitored and managed, so they are supported to stay safe?

Infection control

  • What changes have you made to infection control arrangements to protect staff and patients using the service?
  • How do you ensure staff have the appropriate time for donning/doffing and cleaning between seeing patients? (not relevant to online services)
  • When was your last audit of IPC/PPE/the environment and facilities? What did it tell you and what actions have you taken?

Safety systems and risks to people

  • What actions have you taken in the last six months as a result of learning from serious incidents to ensure people are kept safe?
  • How are patients who need urgent care and treatment identified, prioritised and protected from discrimination?
  • How do you recognise and manage the deteriorating patient? (not relevant to online services)
  • How do you ensure appropriate staffing levels and skill mix to cope with demand? (For example, weekends, bank holidays, seasonal pressures, epidemics)
S3: Do staff have all the information they need to deliver safe care and treatment to people?
  • How do you manage clinical records to ensure safe care and treatment?
  • How do you manage referrals to and from other providers? (not relevant for online providers)
S4: How does the provider ensure the proper and safe use of medicines, where the service is responsible?
  • Have you made any changes to your approach to medicines management? (for example, in relation to repeat prescribing, ongoing monitoring requirements for high risk medicines)
    • If so, what and how has this affected care?
  • How are people’s medicines reconciled, in line with current national guidance, when transferring between locations or changing levels of care?

Effective

E1: Are people's needs assessed and care and treatment delivered in line with current legislation, standards and evidence-based guidance to achieve effective outcomes?
  • How are you identifying, cascading and keeping up to date with changes in clinical guidance?
  • What are your oversight arrangements for clinical care provided by clinical and non-clinical staff?
    • to people in care homes
    • to vulnerable people in their own homes
    • for clinical decisions made during calls
E3: How does the service make sure that staff have the skills, knowledge and experience to deliver effective care, support and treatment?
  • How do you ensure that all staff (clinical and non-clinical), including those being flexibly re-deployed, have the skills and knowledge to carry out their roles and responsibilities effectively?
    • How do you ensure that the staff who deal with patients are operating within the appropriate scope of practice at the point of recruitment, and ongoing? For example, audit of consultations?
E5: How are people supported to live healthier lives and, where the service is responsible, how does it improve the health of its population?
  • How do you ensure that people who are affected by health inequalities are receiving the care they need?
  • How are you promoting good health/targeted approaches in response to coronavirus (COVID-19) and people at risk?

Caring

C1: How does the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed?
  • How have you adapted how you support and engage with patients and their families/loved ones (for example, in the context of more remote working)?
C2: How does the service support people to express their views and be actively involved in making decisions about their care, support and treatment as far as possible?
  • How do you support people to express their views and actively involve them to make decisions as far as possible?

Responsive

R1: How do people receive personalised care that is responsive to their needs?
  • How do you take into account patient choice about how, when, where they want to be seen? (not relevant to online services)
  • How do you ensure that people with information and communication needs are able to access appointments and services in ways that meet their needs?
  • How does care provision take account of the needs of individual people? (for example, Trans people, people who have a disability, people with long term conditions or mental health needs)
  • Have you identified any barriers to care provision, particularly for patients with protected characteristics? For example, disabled people, older people, ethnic groups. If yes, what actions have been taken to combat them?
R3: Can people access care and treatment in a timely way?
  • How are you managing access to services?
    • Do you have backlogs of activity and long waiting times as a result of coronavirus? How are you managing this? What are your recovery plans?
    • How are you ensuring that high-risk/vulnerable patients and pathways are being identified and prioritised appropriately? (not relevant to online services)
    • What are your arrangements to follow-up and support patients whose care and treatment was delayed due to coronavirus? For example, patients with non- coronavirus related issues.
    • How are you ensuring equitable access to appointments when they are needed, especially for people with protected characteristics and vulnerable groups? For example, Trans people, people who are housebound, people at the end of their life. (not relevant to online services)

Well-led

W3: Is there a culture of high-quality, sustainable care?
  • What actions are you taking to protect and support the health, safety and wellbeing of staff, particularly those who are high-risk/staff in different ethnic groups? For example, coronavirus testing
  • How do you promote equality and diversity, and check that staff feel supported, respected and valued?
  • What training and support is available for staff using new technology to deliver care? (not relevant to online services)
W5: Are there clear and effective processes for managing risks, issues and performance?
  • Has your business model/operating model changed since the pandemic? If so, how and what has been the impact on staff and people who use your services?
  • How do you assure yourself that you are providing a safe service? For example, regular audits and increased supervision etc.
  • How are you monitoring business risks and issues, and what actions are you taking to respond to them?
    • What are the arrangements for business continuity? For example, arrangements for diverting calls, contingency planning for staff shortages/ outbreak onsite, changes made in light of coronavirus. How are you flexing the service/models of care to adapt to changing circumstances, including second wave of coronavirus?
    • How are you working with partners to review and update local pathways?
W8: Are there robust systems and processes for learning, continuous improvement and innovation?
  • What systems are in place to support people (staff/people who use your services and their families/carers) to speak up and raise concerns?
  • How do you support people to provide feedback?
Last updated:
25 November 2020