Dr Rosie Benneyworth’s Blog

Regular column for providers and professionals working in primary care from Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services

I want to start this blog with a thank you to everyone working in primary medical and dental services. I know how hard you’ve been working to continue to deliver care to people who need it, including delivering impressive innovation and change in how care is delivered.

My colleague Ian has recently written about the work we are doing across CQC to develop our regulatory approach now, next and in the future. Following on from this and from my recent messages in June and July I wanted to update on how we are continuing to develop our regulatory approach, focusing on a pilot we are undertaking with general practice that we hope will give us more and improved options to gather information from providers.

Developing our regulatory approach

I want to emphasise that during the coronavirus (COVID-19) pandemic our regulatory role has not changed and our core purpose to keep people safe is at the heart of all the decisions we make.

For example, changes we made to our regulatory approach, including pausing routine inspections, and only inspecting based on risk or where there are concerns around people’s safety and human rights. At the time this was the right thing to do so we could support providers to keep people safe, allow them to focus on responding to the emergency, avoid our inspectors spreading the virus inadvertently, and reduce demand for scarce personal protective equipment (PPE).

We also developed a new monitoring tool our Emergency Support Framework (ESF), which supports inspectors to understand where people may be at the greatest risk of unsafe care.

And on the 3rd July I wrote about work we are doing to develop a transitional regulatory approach that will start being used from September. This isn’t a return to our pre COVID-19 approach. Our activity will continue to be targeted at providers where there are concerns and due to the pandemic may mean not returning to frequency-based inspections. We will also use more information we hold about not only individual providers, but also about local systems to understand where there are barriers to good care.

It’s important that to ensure our transitional regulatory approach supports providers to improve care, we work with you to develop it. So, in early August we have been hosting a series of engagement events to gather your views on our transitional approach. We will also soon have further opportunities to feedback through our digital engagement platform. I am keen to make sure we hear from a range of people who work in primary care, so if you’re interested in engagement opportunities like this then please let us know.

Piloting new approaches

The coronavirus pandemic has resulted in fundamental changes to the way that care is delivered, and we need to be more flexible and responsive in the way we regulate so we don’t stifle this innovation or add unnecessary burden to providers.

We will continue to inspect where there is risk to safety and people’s human rights and where there is evidence the quality of care needs to improve. We will also be working to develop how we monitor services and collect information from them without having to visit a provider.

One way we will do this is through piloting the use of an assessment and monitoring approach with a small number of General Practice services that will give us the opportunity to gather evidence from providers without crossing the threshold. This means that inspection teams undertaking this work, will be working as far as is possible without visiting the service, and will include digitally accessing clinical records for assessment where needed.

This work will be focused on areas of risk and at this point will only be used where we have assessed there are potential risks to patients or existing breaches of regulation and for practices currently in special measures. It’s not an inspection and will not result in a rating. Participation is voluntary and practices will be informed of the implications of agreeing to take part.

We hope this approach will enable us to collect information from a provider in a more flexible and responsive way that is less disruptive and requires less input from providers.

We will be contacting practices where we would like to use this approach with more information over the next few weeks, including the safeguards we will use to ensure the right level of information security.

Our future strategy

All the work we are doing to develop our transitional approach and pilot new ways of working will also support the development of our future strategy and our longer term regulatory approach. This work is ongoing now and you can find out more about it by watching a series of recent webinars or listening to our podcast episodes on our future strategy.