The existing key lines of enquiry (KLOEs) are being replaced with 34 new ‘quality statements’, that will define what is to be expected from a GP Practice. Here we look at what they mean.

The CQC states that this will enable them to make judgements about the quality of care being provided, using understandable standards and expectations that are focused on people.

These will also put a greater focus on risks in practice, and providers will be expected to self-report to the CQC through its provider portal. This data-driven approach to inspections is designed to improve the transparency and consistency of reporting for all care providers, and the portal will also provide a space for care providers to seek advice and guidance, enabling a higher quality of care to be delivered.

What Evidence should I present?

There will be six categories covering the evidence that the CQC will collect during the quality assessment process:

• People’s experiences
• Feedback from staff and leaders
• Observations of care
• Feedback from partners
• Processes
• Outcomes of care

The evidence needed to support these categories is comparable to what is currently in use, but the new framework is intended to give greater order and a clearer procedure on how they collect and use the data to work out the final rating (although there will still be ongoing quality reviews).

Some suggested evidence could be the following;

Safe

• A record of serious untoward incidents/significant events from the last 12 months (including investigations, actions taken & how you implemented the learning from the event)
• Safeguarding, recruitment and fire safety policies and procedures
• information on the current number of staff by role, their full-time equivalent (FTE), and any qualifications or training provided to them in the last three years. This includes training in areas such as safeguarding, fire safety, infection prevention and control, equality and diversity, medical emergencies and sepsis awareness, mental capacity, and chaperones.
• Risk Assessments and action plans (e.g. Fire, health & safety, premises)
• Up to date Cleaning Schedule (including recent Infection Prevention & Control audit and action plans)

Effective

• Staff performance management policies and process
• Policies on remote consultations (e.g. video/digital consultation policy)
• Quality Monitoring of treatment and services (e.g. clinical audit cycles from the last 12 months)

Caring

• Complaints & Feedback from the last 12 months (including investigations, actions taken & how you implemented the learning from the event)
• Accessible Standards policies and processes

Responsive

• Patient Surveys carried out in the last 12 months (including any findings and actions taken following the results)

Well Led

• Practice Statement, Visions and Values
• Business Continuity Plans
• DSP Toolkit compliance, and that the practice is registered as a data controller
• Meeting Minutes from practice meetings, clinical/information governance meetings, PCN related meetings and others.

Can Providers challenge the CQC’s Assessment?

In December 2022, the Administrative Court made a ruling in a case brought by Hexpress Healthcare Limited against a CQC inspection report. The central issue was whether the provider being inspected has the right to challenge the CQC’s assessment and request an independent review.

The case looked at two important issues regarding the CQC’s processes for inspection and assessment of services and challenging inspection reports. It concluded that the provider should not have a further right to request an independent review upon receipt of the CQC’s factual accuracy challenge response. More information on this case can be found here.