We asked our columnists for their views on CQC practice inspections.
The Apprentice columnist Dr Laura Davison, a GP in Milton Keynes, writes that the CQC is about service not qualifications
You’ve got your stethoscope, your spell checker exempt sphygmomanometer, your NICE guidelines, your well-thumbed BNF copy and your patient list. You are ready to do battle in the GP Arena. Or are you? Do you know what disinfectant you need to mop up the vomit in the waiting room? Do you know where to find your practice Safeguarding Protocol? When was the last time you filled out a yellow drug card for Mrs Simpson and her loosely-associatedwith- her-new-drug “giddiness”?
I, apparently, am therefore utterly unprepared for CQC. This is what they’re after – not whether you’ve got carpet in your office or toys in your waiting room. They’re not bothered that you’ve got an MRCGP certificate on your wall (mine’s still in its roll in my loft if they do ask for it), this is about service not qualifications.
CQC, as much as we dread their call and imminent descent upon our practice havens, are here to ensure we deliver care that meets their standards and stamps out bad practice to protect our patients. And rightly so. The vast majority of us work in efficient, clean, well-functioning practices, and now we just have to prove it. My poor practice manager bored me senseless with her foot-thick folder on CQC preparation paperwork, but think of the preparation not as a character defence but an opportunity to show off. Demonstrate how proud you are to work for your organisation, and in return, you might actually learn something new about your practice.
CQC inspections are not about box-ticking that you have a policy in place, but that all team members are aware of the processes of others and know where to get information and how to help the team provide the ultimate service. It’s not good enough to just say: “I’d ask Jean in reception about that” – what if Jean’s not there?
It might actually be helpful to know about the different disinfectants and where they’re kept. The number of times I’m the only health professional at the end of a session leaves the awkward possibility of leaving a grim present for the cleaner later that night rather than being helpful to the team and dealing with it myself.
As GPs we need to be on top of what is expected of us, educate the rest of our practice troops and lead them fully prepared into the onslaught of questioning if, and when, the inspector hordes arrive. I better go ask Jean where the bleach is.
CQC: the new religion – Locum columnist and editor of the British Journal of General Practice Dr Euan Lawson, says there is a new deity in town
While locuming recently I noticed a laminated sign above the monitor telling me to sit up straight. I’m used to the dog-eared lists of phone numbers, but advice on ergonomics is unusual. I suspected a higher power was at work. We may have spent nearly a decade genuflecting to QOF, but there is a new deity in town.
In biblical terms the CQC is more Old Testament than QOF and GPs may feel that a plague is descending on their house. The CQC are falling on practices like the Four Horsemen of the Apocalypse. Only with suits, clipboards and a fetish for laminated posters.
Nit inspections. Dental inspections. Drain inspections. No one likes being inspected. Tax inspectors take your money. Inspections reek of state interference – intrusive and usually more than a little demeaning. I can’t think of any inspection without recalling Viz comic’s notorious The Bottom Inspectors. You can guess their role and we won’t dwell on the Chief Inspector of General Practice at this point.
In addition, it is presumably only a matter of time before we see practices hoisting up banners, as seen outside schools, proclaiming “We are outstanding!” Those surgeries that don’t make the highest grades are unlikely to unfurl giant posters declaring “We could do better with the patient toilets!” or “We got rid of the maggots!”
It’s easy to carp about the CQC, but I was recently asked to imagine a town where there was only one garage where I was allowed to take my car. The government pays for the garage, but doesn’t check on the standard of service they provide for my car. In the face of this analogy, I paused and grudgingly conceded that some kind of modest inspection might be reasonable. And it was hard to argue when it was offered to me by a GP partner who is spending a lot of time and effort improving the care in his practice as a response to CQC. I noted wryly that the glass on his desk was definitely half-full. Probably vodka.
Even locums can do their bit and so I have resolved that I will keep my lunchtime yoghurt in the staff kitchen and never consider the temptingly close and reliably cold vaccine fridge. My lunch is now worryingly near to the senior partner’s science experiment, but we all have to make sacrifices to appease the CQC gods.