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How we determine your aggregated ratings: primary medical services

  • Organisations we regulate

Using professional judgement

To ensure that we make consistent decisions, we follow a set of ratings principles and apply professional judgement when rating at population group and key question level. Our ratings must be proportionate to all available evidence and the specific facts and circumstances.

Before we start an inspection we will identify whether a service is delivered by a provider that we would usually rate at provider level, for example an NHS trust. If it is, the ratings approach for NHS trusts would apply at the provider level, in addition to service level rating.

If we identified concerns in the inspection we’ll consider the following criteria and use our professional judgement to decide whether to depart from applying the ratings principles – particularly where we need to aggregate ratings that range from inadequate through to outstanding:

  • The extent and impact of the concerns on people who use services and the risk to quality and safety, taking into account the type of setting and the population group (for services where we look at these). If concerns have a very limited impact on people, it may reduce the impact on the aggregation of ratings.
  • Our confidence in the service to address the concerns, or where action has already been taken.

We can’t predict what future models of care and configurations of services will look like. To enable us to be flexible and respond to change, we will base our approach to aggregation for future models of care on these principles. 

Where a rating decision is not consistent with the principles, we will record the rationale clearly in the inspection report and the decision will be reviewed by a national quality control and consistency panel.

Updating ratings

The change to how we rate the six population groups means that all previous ratings for population groups for the safe, caring and well-led key questions will be removed after the next inspection of your practice. We will carry forward the other ratings from previous inspections and aggregate them with updated ratings.

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 inspection.

A change to a rating for a key question can result in a change in an overall rating for a provider when we apply the ratings aggregation rules.

After we have published an inspection report, you must display your updated ratings in relevant locations and on your website.

Last updated:
24 May 2018


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