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

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I want to start this blog by saying thank you. During the pandemic, we know that primary care services have worked and continue to work extremely hard to ensure that people continue to receive the services they need in a safe and effective way.

I know that this has been challenging.

It’s also been impressive how providers have been able to quickly innovate and develop new models of care to meet the needs of people receiving services and keep them safe.

During the pandemic our regulatory role has not changed, and our core purpose of keeping people safe drives our decisions. We have adapted how we work to act in a proportionate way and offer support to providers where they need it.

In this blog I want to talk about how we will continue to do this.

Our transitional approach

My chief inspector colleagues and I wrote recently about the launch of our transitional regulatory approach.

This approach builds on work we have done during the pandemic, including looking more at areas where quality needs to improve.

But is not a return to our pre COVID-19 approach.

It gives us a flexible way to understand through monitoring where there are risks, hear more from people who use services and where appropriate target our inspection activity.


Earlier this year we announced a pause in our programme of routine inspections. This did not mean we stopped inspecting completely. We continued to inspect where there was risk to safe care, and it was the appropriate thing to do.

I want to emphasise that our transitional approach does not include a return to a programme of routine inspections.

We will continue to inspect where it is the only way to address concerns around safety and the quality of care. When we do inspect, we will do as much activity as possible without visiting a provider. This will include inspections of services currently in special measures.

To support this approach, we are also piloting new ways of working including the use of an assessment and monitoring approach with a small number of General Practice services. This 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, including digitally accessing clinical records for assessment where needed, with providers’ consent.


Our transitional approach includes improved monitoring of services that builds on our Emergency Support Framework.

Our inspectors will look at information from a range of sources and hold a short telephone conversation with providers, exploring a reduced set of KLOEs (Key Lines of Enquiry). These KLOEs will be published on our website and the prompts will be available for feedback through our digital platform. This will help to inform future iterations.

These calls are not a form of inspection but are a way for us to understand the challenges a provider is facing and whether there are any risks to quality and safety. It will also help us identify where a provider can be offered support.

It’s important that these conversations are open and transparent. In particular we want to know how other parts of the system are affecting primary care.

We can also escalate issues related to responding to coronavirus to influence the national system response. This will include the sharing of key trends and issues with the Department of Health and Social Care, using our independent voice to highlight key trends through regular publications, and where appropriate escalating through NHS England/Improvement incident centres.

Alongside this work with providers we are also continuing to listen to people who use services and encouraging them to share their experiences of care.

This work is important because it enables us to share an accurate picture of the challenges the sector is facing and the good work you are doing to deliver care. This will give the public assurance around important issues such as safety and access.

Looking to the future

Our transitional approach will be flexible and responsive to the changing situation. We will also continue to develop it based on feedback we receive. There will be opportunities to feedback in the coming weeks through our digital engagement platform.

Our learning from our transitional approach will also support the development of our future strategy. You can read more about this from our chief executive, Ian Trenholm and a recently published document setting out our latest thinking on a range of key areas.

As we develop our strategy further, we will want to hear from you so that we regulate in the best way for the future.

Thank you again for all the hard work you do.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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