1. Inspection of General Practice Andy Brand Inspection Manager 1

2. The Care Quality Commission and our new inspection approach The Care Quality Commission is the independent regulator of health and social care services in England. Register, monitor and inspect. Publish reports. Powers of enforcement. We are looking to improve the way we inspect OOH services by inspecting against five domains and inspecting service groups 2

3. Our new approach Our purpose: We make sure health and social care services provide people with safe, effective, compassionate high-quality care and we encourage services to improve. Our role: We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care. Our principles: We put people who use services at the centre of our work We are independent, rigorous, fair and consistent We have an open and accessible culture We work in partnership across the health and social care system We are committed to being a high performing organisation and apply the same standards of continuous improvement to ourselves that we expect of others We promote equality, diversity and human rights 3

4. Better, more systematic use of people’s views and experiences, including suggestions and complaints. New expert inspection teams including trained inspectors, clinical input led by GPs and nurses, practice managers and GP Registrars. A rolling programme of inspections carried out systematically in each CCG area across England. Inspections of GP out-of-hours services to be incorporated into CCG area programmes. A focus on how general practice is provided to key patient groups, including vulnerable older people and mothers, babies and children. CQC top 10 changes

5. Tougher action in response to unacceptable care, including where necessary closing down unsafe practices. Ratings of all practices to help drive improvement and support people’s choice of surgery. Better use of data and analysis to help us to identify risk and target our efforts. Clear standards and guidance to underpin the five key questions we ask of services: are they safe, effective, caring, responsive and well- led? Close collaborative working CCGs and Local Area Teams of NHS England to avoid duplication of activity.

6. What do we mean by safe, effective, caring, responsive and well led? Safe By safe, we mean that people are protected from avoidable harm and abuse. Effective By effective, we mean that people’s care and treatment is evidence- based and achieves good outcomes, including the prevention of premature death, the achievement of a good quality of life, and at the end of a person’s life, the achievement of a ‘good’ death. Caring By caring we mean that people are treated with kindness, dignity and respect. Responsive By responsive, we mean that people’s individual needs are met without avoidable delay. Well-led By well-led, we mean that the leadership and governance of the organisation holds itself and others to account for the delivery of effective, high quality care, welcomes challenge and promotes an open and fair culture 6

7. Focus of our inspections – key population groups We will always look at services at a location (GP practice) level through the lens of six patient groups. For every NHS GP practice we will look at the quality of care for the following key patient groups: Older people (over 75s) People with long term conditions Mothers, babies, children & young people Working age population and those recently retired People in vulnerable circumstances who may have poor access to primary care (e.g. homeless people, people with learning disabilities) People experiencing a mental health problem

8. Ratings: Proposed approach Inadequate Requires Improvement Good Outstanding 8

9. Rationale for ratings The public want information about the quality of services in an easy to understand format Ofsted approach seen as the model. Healthcare provision is more complex. Service ratings more useful. Ratings as potential driver for improvement 9

10. Rating practices

11. Timelines Published signposting document setting out high level proposals Dec 2013 First wave of GP out-of-hours providers (approximately 30 providers) Jan-Mar 2014 Public consultation on draft inspection handbook and Wave 1 of testing (200 practices in 12 CCG areas) April – June 2014 Wave 2 of inspections (300 practices), ongoing testing and refining of our revised approach July – Sept 2014 Oct 2014New approach fully implemented. Ratings awarded. By April 2016 Every NHS GP practice and NHS GP out-of- hours inspected and awarded ratings

12. Specialist Advisors If you or any of your colleagues would be interested in becoming involved in a CQC inspection, please send the following information to our recruitment team at primarycarerecruitment@cqc.org.uk primarycarerecruitment@cqc.org.uk CV (please include full name, email address and contact number) Short Biography (just a few key professional milestones) The reference details (including email addresses) of 2 referees, including your current or most recent Line Manager/Managing Partner/Director etc.

13. Questions