By Robin Stride
Independent practitioners are being advised to gear up now for this year’s changes in Care Quality Commission (CQC) inspections.
It is recommended they should begin reviewing their systems to extract evidence to demonstrate effective quality assurance.
A management expert who helps private doctors achieve registration with the watchdog is also drawing attention to a new approach from inspectors as they replace inspection-only visits with continuous evidence collection, heralding more targeted future inspections.
New interactive portals later this year aim to enable providers to upload audit, survey and incident investigation data so the CQC can keep a constant eye on activity.
Martha Walker, the Independent Doctors Federation’s (IDF’s) adviser on CQC matters, says there will be increasing emphasis on dialogue with providers via monitoring calls, which increased last year.
Monthly calls imminent
Writing in the Spring 2023 edition of IDF News, she warns that monthly hour-long calls are imminent.
She says: ‘The monitoring call does not involve the doctors sending any evidence to the inspector; however, if the inspector had a cause for concern during the call, they may ask for evidence to be submitted to them or undertake a more targeted conversation or site inspection.’
Mrs Walker, of CQC Consultancy, reports that doctors have found it positive to be able to explain changes to their service or talk about how they handle complaints and unexpected events.
But she adds: ‘I still caution doctors to be mindful of these – and all – conversations they have with the CQC, as they are calls to monitor how your practice is performing.’
Private doctors applying to register now face having to provide more quality assurance evidence than previously and can expect ‘at some stage’ to receive a provisional rating of ‘Good’.
Quality statements introduced
The 300-plus ‘key lines of enquiry’, known as KLOEs and introduced five years ago, are also due to be dropped and replaced by 34 quality statements across the five key questions asked about services – are they safe, effective, caring, responsive and well-led.
All four rating categories – outstanding, good, requires improvement and inadequate – remain.
More CQC information on various issues is awaited, including evidence category guidance, which will be crucial ‘because the quality of the evidence will form part of the new scoring system’.
How the scoring system will work to determine ratings is another unknown and Mrs Walker throws up another important concern for independent doctors:
‘With substantial weight being placed on data to demonstrate the quality statements and provide supporting evidence, and EMIS apparently being the CQC’s preferred practice management software, how will the majority of independent doctors be assessed, as EMIS for private health care is not the market leader in the independent sector?’
‘There is no one practice management software package used in the sector and will doctors feel pressurised into investing into EMIS for private healthcare or risk being penalised for not using it?’
Giving his IDF president’s report in the same journal, Dr Phil Batty told members he had regular meetings with the CQC ‘to try to make the inspection process easier and equitable, especially for minority led practices who may have different practice demographics.’
IDF can help you
Dr Phil Batty
IDF president Dr Phil Batty has asked any doctor members with specific concerns about CQC matters to contact him.
In a message to members, he welcomed plans for a portal where documents and work can be uploaded for live inspection.
But he said he had voiced concern to the watchdog that some inspectors might have unconscious, or conscious, bias against private practices.
Dr Batty reported: ‘I am assured there have been communications that all practices should be inspected in the same way, whether they are NHS or private.’