South Central Operationalisation of NHS England Framework for Responding to Care Quality Commission (CQC) Inspections of GP Practices
NHS England, South Central Operationalisation of NHS England Framework for Responding to Care Quality Commission (CQC) Inspections of GP Practices Version number: 1 First published: February 2015 Prepared by: Ginny Davies, Quality Safety Lead and Rebecca Tyrell, Quality Improvement Manager, Jan Fowler Director Nursing (NHS England, South Central). Page 2
1 Introduction In October 2014 NHS England published a Framework for responding to CQC inspections of GP Practices, outlining the response expected to Primary Care contractors, when compliance issues have been identified through their inspections. This paper summarises the locally agreed approach by NHS England, South Central, South Central Clinical Commissioning Groups (CCGs), local Care Quality Commission (CQC) Primary Care Inspectors in conjunction with the framework mentioned above. 2 Agreed local processes following CQC inspection finding compliance issues in GP practices for South Central Sub Region and CCGs Following notification that a GP Practice has been identified as having compliance issues, to ensure there is a consistent level of intervention, additional support and relevant assurance the processes have been spilt into three scenarios: 1. Overall GP Practice Inadequate (Special Measures). 2. Overall GP Practice Requires Improvement rated Inadequate in one of the key domains. 3. Overall GP Practice Requires Improvement. 2.1 Process following CQC Inspection GP Practice found overall Inadequate (Special Measures) CQC will notify and schedule a meeting / teleconference with NHS England (representation from Quality Team, Primary care Team, Medical Directorate, Comms Team), CCG and LMC to inform them of the GP Practice which has been found Inadequate following a CQC inspection. NHS England, CCG, LMC will meet with the practice and agree next steps. This may involve an initial meeting with the Senior Partner and Practice Manager to explain the process and support available. Access to RCGP support package/ alternative to be agreed, including funding. NHS England dedicated support to develop quality improvement action plan (see pages 36 40 and 41 42 in Framework for responding to CQC inspections of GP Practices ) in addition to Communications Strategy and implementation plan, Patient involvement and Practice support to be implemented. CCG full engagement. Support as required. Oversight process to be agreed in line with agreed timescales likely to be monthly meetings (see Appendix 1 for proposed terms of reference). Risk log management. Potential contractual and remedial actions (Part 2 of Oversight meeting). Mock Assessment/Peer Review ahead of 6 month follow up CQC inspection. Page 3
2.2 Process following CQC Inspection GP Practice found overall Requires Improvement rated inadequate in one of the key domains CQC will inform NHS England of the GP Practice which has been found requires improvement - rated inadequate in one of the key domains following a CQC inspection. NHS England to inform CCG. NHS England to arrange improvement meeting with the practice and CCG, to agree next steps including development of improvement action plan (to include Communication Strategy) and support required from NHS England and CCG. NHS England and CCG as appropriate to monitor improvement plan within agreed timescale. To involve monthly progress reports against action plan / instigation of Oversight meeting, to be agreed. Mock Assessment/Peer Review. 2.3 Process following CQC Inspection GP Practice found overall Requires Improvement CQC will inform NHS England of the GP Practice which has been found requires improvement following a CQC inspection. NHS England to inform CCG. NHS England to arrange discussion with the practice and CCG to agree next steps including potential development of improvement action plan (to include Communication Strategy) and support required from NHS England and CCG. NHS England and CCG as appropriate to monitor improvement plan. 3 Implementation This document is a local operational process outlining the governance arrangements for contract and quality assurance for Primary Care and the agreed approach taken to respond to CQC inspections where compliance issues have been identified. 4 References Framework for responding to CQC inspections of GP Practices, NHS England, October 2014. Page 4
5 Appendix 1 Oversight Assurance Group Proposed Terms of Reference Membership NHS England, South Central Director of Nursing and Quality NHS England, South Central Director of Commissioning NHS England, South Central Medical Director/ representative as required NHS England, South Central Head of Primary Care NHS England, South Central Assistant Director of Nursing Clinical Commissioning Group Representation including clinical representation GP Practice Representation including lead for quality RCGP Team member/s LMC CQC (as appropriate for specific items by invite) Any other organisations by invite Purpose To provide support to the practice and, assurance to stakeholders of the delivery of high quality care and experience to patients of XXXX Surgery. Specifically in achieving full compliance with CQC minimum standards and, ultimately in support of the practice delivering its overall quality improvement priorities. 1. To monitor assurance and delivery of XXXX Surgery quality improvement plan to achieve full compliance with CQC minimum standards. 2. To provide a forum where stakeholders can support XXXX Surgery, where system wide solutions and support are required. 3. Develop a single, coordinated communication for external stakeholders, patients and public. Ensuring consistency in communications. Operations 1. Meetings will be held monthly, venue to be confirmed. Meetings will continue until the XXXX Surgery has delivered agreed action plan or until it is superseded by alternative arrangements agreed by member parties. 2. Administration agenda, minutes, meetings set up will be managed by NHS England South Central Nursing & Quality team. Meetings will be minuted, Agenda and papers will be circulated at least 2 working days prior to each meeting. 3. Meetings will be chaired by the NHS England South Central Director of Nursing or Director of Commissioning. Quoracy will include minimum of 5 members, to include 1 CCG, 2 NHS England South Central (1 from commissioning and 1 from quality) representatives and 2 practice members. 4. The meeting will report into the South Central Quality Surveillance Group. Part Two of meeting (as required) to manage any contractual issues. This part of the meeting to be attended by NHS England, CCG, LMC, with others by invitation. Page 5