Prof. Steve Field’s monthly blog

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

In this month’s column I talk about the increasing use of triage apps within general practice and how CQC plans to consider them when on inspection. I also want to talk about the new role of nursing associate, and things that you should consider as providers.

Triage apps

Nobody can deny that primary care is changing rapidly. These changes are being driven, in large part, by the well-documented pressures facing the system.

The increasing use of triage apps and solutions are just one example of the changes that we’re seeing in primary care, with a growing number of practices and providers using them.

In September 2018, following legal counsel, it was agreed that CQC should consider triage apps as “ancillary activities” where they are part of a pathway of care. This means that they come under the scope of CQC’s regulations whether done by an individual or electronically; within the provider’s premises or contracted out to a third-party supplier; in independent health or NHS.

This month we published additional prompts to help us look at triage apps on inspections of healthcare services. We will explore how the triage solution is being used to make sure that care is safe and high quality. They are one part of the inspection process and will be used alongside the existing healthcare framework and should be seen as a route to encouraging the right conversations between you as providers and our inspectors.

We have tested and refined them with a number of key national stakeholders, as well as with providers. We will continue to refine them to ensure that they work for CQC, providers, and the public.

I believe that the innovative use of technology has the potential to play a major part in how healthcare is provided and we are seeing the way that care is delivered evolve. As new systems develop, we need to make sure that people are still able to access the appropriate, high quality care that they deserve.

As a regulator, it is important that we continually adapt our approach so that regulation takes account of the different ways that care is delivered to people, and our reports provide a clear picture of the care that people can expect.

Nursing associates

I talked above about the well-documented pressures in primary care and the need to come up with innovative ways to address these challenges. Introduced this month, the new role of nursing associate is intended to bridge a gap between health care support workers (and social care equivalent) and registered nurses. The hope is that this is one step to ensuring an adequate workforce to face the challenges of now and the future.

Since 28 January 2019, nursing associates have been able to apply for registration with the Nursing and Midwifery Council (NMC) and must uphold the NMC’s Code of professional practice. As registered professionals, they are individually accountable for their own professional conduct and practice.

As providers, there are also some things for you to consider when using nursing associates as part of your service. We produced this briefing to help you.

On inspection, we will want to see evidence that providers have adopted a systematic approach to deploying nursing associates, ensuring that they have considered the risks to the quality and safety of care for people who use services.

In our publication, Driving improvement: case studies from 10 GP practices, we talked about the value of practices working as a multi-disciplinary team. When deployed safely, and within the Regulations, nursing associates can bring vital qualities to a practice team and when employed as part of a team of other healthcare professionals, they have the capacity and potential to help improve outcomes and experiences for people who use services.

Have a great month everyone.


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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