Prof. Steve Field’s final blog as Chief Inspector

Monthly column for providers and professionals working in primary medical and dental services from Prof. Steve Field, Chief Inspector of General Practice

In my final column as Chief Inspector of General Practice I want to update you on our approach to regulating general practice, our expectations and requirements surrounding the new intercollegiate guidance on safeguarding and also a final goodbye message.

Update on how we regulate general practice

Earlier this week I wrote to all GP practices about changes that we are introducing from April 2019. The next stage in our phased implementation of our new approach to the regulation of general practice.

The introduction of an annual regulatory review will bring structure and consistency to our monitoring of GP practices as we move to reinspection intervals of a maximum of five years for practices rated as good and outstanding.

This approach will help us to prioritise our inspections where there has been most change, either deterioration or improvement. We can then continue to focus where risk is greatest while also supporting practices to improve. It will also enable us to move to more focused inspections that concentrate on those areas of most change.

Read more about what this means for you and your practices on our website.

Intercollegiate guidance on safeguarding

In August 2018 the intercollegiate guidance on adult safeguarding was published. This was followed by the equivalent guidance for children and young people in January 2019. These documents set out the roles and competencies expected of health care staff.

Both sets of guidance represent important cross-organisation work. To support their implementation, and provide clarity to those working in general practice, we have updated both mythbusters relating to safeguarding.

From CQC’s perspective, we accept that there are new requirements within both pieces of guidance and will take time to embed within general practice. We would expect that you have reviewed the guidance and have plan in place for all staff to work towards meeting the necessary requirements. We would expect that staff would still be to safely and effectively manage safeguarding concerns, even if you cannot provide evidence of formal training.

You can view both updated mythbusters on our website:

· Safeguarding adults at risk

· Safeguarding children.


This is my final blog to providers as Chief Inspector at CQC. It has been immensely rewarding and a privilege to work at CQC for the last five years.

I accept that it has not always been easy, but we have come a long way in our journey. We now have an unprecedented view of quality in general practice, enabling us to adopt a more targeted and responsive approach to focus on the areas of most need and highest risk.

Through the hard work of GP practice teams, we have seen standards improve across the board to the point where at our last assessment, 96% of GP practices were rated good or outstanding. This is testament to the fantastic work that you do in delivering high quality care to patients up and down the country.

Our work looking at how local systems work for the over 65s has been ground-breaking in its scope. We have conducted 23 reviews so far, and I welcome the announcement from the Department of Health and Social Care to approve further reviews next year. These reviews have immense local and national benefits and can play a key role in supporting providers and commissioners to work better together, now and in the future.

You will have seen this week that in April I’ll be taking up the next chapter in my career as Chair of The Royal Wolverhampton NHS Trust. Having lead on integration for CQC, I’m looking forward to supporting Wolverhampton continue the great work they are already doing in this area. Ensuring people get the high quality, compassionate care that they deserve was the reason I entered the profession in the 1980s, and I hope to continue to be able to do this in my new post.

I want to say thank you to my team that have supported me throughout the past five years, Rosie is inheriting a passionate and dedicated group of professionals. I especially want to thank Professor Nigel Sparrow who, many of you will know, was a GP for many years and has worked with me at the RCGP as well as here at CQC. He has worked tirelessly to ensure that the clinical voice is heard and to make sure that we have the best regulatory system for general practice that we possibly could. He has been absolutely brilliant.

Lastly, I want to thank you to you as providers, across the full spectrum of primary medical and dental services, for your hard work. It has been a pleasure working with you across the country. I know that together we can continue to improve quality and deliver better care.


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