The CQC Visit
The CQC expects GP practices to spend around 30 minutes at the beginning of the inspection visit describing the practice, its ethos, what it does well, etc. This article will address how to prepare this presentation but some Practices may wish to take a different approach in preparing and delivering their 30 minute presentation. There is no specific format or media required for the 30 minute presentation and the practice can choose whatever format suits them. Practices may choose to involve patients, staff (including attached staff) which helps evidence compliance with the regulations. Practices should be open and share their views with the CQC. CQC inspectors want to get to the core of people’s experience of care, so the focus of their inspections is on the quality and safety of services, based on the things that matter to people.
Promote the Practice
The CQC Inspectors will use their judgement, supported by objective measures and evidence, to assess the services provided against their five key questions – Safe, Effective, Caring, Responsive and Well-Led. CQC Inspectors will validate the evidence they have already collated before the inspection, so the 30 minute presentation is one of the best and the earliest opportunity to describe the background and ethos of the practice and to evidence the practice provides quality services and safe care against the five key questions and the six population groups.
It is important to promote the Practice in terms of demonstrating examples of outstanding care and services and how the Practice has recognised the areas in which it needs to improve, including how it is already addressing those areas and how quickly it believes it can achieve its objectives. Patient feedback and statistical data are often advantageous to support examples of excellent care and could mean the difference between a Good and an Outstanding rating, or could show proactive evidence in the event of a Requires Improvement rating.
What to include
The format can be anything the Practice chooses but a suggested layout should include the following:
- Information about the Practice and staff – if the Practice is a training Practice or offers a specialist service.
- The Practice population – including catchment area, patient demographics and prevalence.
- IT – which clinical system the Practice uses, any IT developments, patient online services available, and the electronic prescription service (EPS).
- Appointments – clinic times, how they are booked, e.g. on the day, in advance, telephone consultations, online, extended hours offered and which patient groups this benefits.
- Quality & Outcomes Framework (QOF) – last year’s achievement, areas difficult to achieve, intelligent monitoring report feedback.
- How the practice meets the needs of the six population groups – older people, people with long term conditions, families with children and young people, working age people, vulnerable people, and people with poor mental health.
- Safeguarding – who the Practice lead is, what training staff have received and their understanding.
- Federations – what involvement the Practice has had, or its views and participation in local projects.
- Patient Participation Groups (PPG) – include a PPG member during the presentation if possible or feedback from the PPG, including any surveys and results.
- Complaints and Significant Events – examples and learning outcomes, but also include compliments and positive feedback.
- Training and Education – training for clinical and non-clinical staff, evidence of staff appraisals, details of in house education and protected learning time (PLT), and how these all benefit patients.
Other key things to include
The CQC inspection team will have seen many presentations in the past so, to make it informative and engaging giving as much detail about what the practice does which may be different to other practices. Describe how services are provided in collaboration with community health teams, or if there have been any difficulties to achieve this. Some practices have had trouble engaging regularly with district nursing teams, school nurses or health visitors. This may significantly impact on care for patients so practices should demonstrate how they are trying to address this.
Discuss the practice band on the CQC Intelligent monitoring and share any relevant information which helps to explain why the practice may show up on particular indicators as an outlier, whether the practice believes that it is a true indicator of risk and what, if anything, the practice has done in relation to that indicator. Also mention all the enhanced services that the practice provides and how participation in these services improves patient care.
Identify clearly how the practice is well-led for example training and supervision, staff meetings, whistleblowing policy, how to improve quality, deliver safe care and services, listening and responding to patients views and complaints, how risks are identified, mitigated and managed and mention any challenges, threats with examples of how these are overcome.
Prepare Now
There is much to include in the 30 minute presentation so the key message is to start preparing now, if you haven’t already had a CQC inspection. Preparation is the single most important part of making a successful presentation and it will save time in the busy two weeks from being notified to the visit itself and can always be added to if necessary. Not only will good preparation ensure that you have thought carefully about the messages that you want and need to communicate it will also help boost your confidence.
Many presentations benefit from personal anecdotes, real-life situations or hypothetical examples to bring them to life and using visual illustrations can be used to clarify or simplify the subject. Illustrations of any type should be relevant and fully explained. Keep in mind that the presentation is likely to last longer if visual aids are used but don’t use visual aids just for the sake of it, there is nothing more distracting than sophisticated technology and pointless PowerPoint animations in a presentation.
