Dear colleagues,

I want to start this message by thanking you for your continued hard work and dedication in delivering primary care over one of the most challenging winters the country has ever seen. Your response has meant people have continued to receive care despite the difficult circumstances and alongside a monumental vaccination programme.

Throughout the pandemic, CQC’s regulatory role has not changed. Our core purpose to ensure that safe, effective, compassionate and high-quality care is provided to the public has remained at the centre of our activities and this will continue.

In March 2020, we paused routine inspections and focused our activity where there was a risk to people’s safety. This was the right thing to do and we have kept that decision under review. From January onwards we have continued to only undertake inspection activity where there were risks to people’s safety or where it supported the health and care system’s response to the pandemic.

Going forward we want to have an active role in encouraging system-wide recovery. As we move into the spring, we are looking to the future and how we can support this. We want to ensure our future approach to regulation is right and meets the challenges of a changing health and social care sector. Below is an update on the work we intend to take forward from April onward.

How CQC’s approach to inspecting primary medical services is changing from April

We will continue to undertake inspection activity that either helps create capacity to respond to COVID-19 or that responds to risk of harm to the public. We will also be continuing to develop the TMA approach to monitoring. From April 2021, we will also be undertaking some additional activity:

• working jointly with Ofsted to deliver multi-agency inspections of children’s services and review approaches.
• working jointly with HM Inspectorate of Prisons (HMIP) and other inspectorates to inspect health and social care in secure settings.
• resuming inspections of independent primary care providers focusing on high/medium risk providers who have never been inspected or where no rated inspection has taken place.
• resuming inspection of GP, out of hours and 111 services that have breaches of regulations including those rated as inadequate, requires improvement and good with breaches of regulation, along with services rated as requires improvement where there are no breaches of regulation. We will also inspect services that are newly registered have not been inspected during the 12 months since registration, or the 3 months since registration for online services. These will be focused inspections looking at three key questions (safe, effective and well-led), as well as any other key questions rated as requires improvement/inadequate and any other areas identified as a concern from previous inspection.
• commencing a programme of focused inspections for oral health providers exploring an increased use of technology.

We are also continuing to undertake work looking at quality across health and social care systems. Our programme of provider collaboration reviews will continue, which explore how systems have worked together throughout the pandemic to deliver positive outcomes and experiences for people using their services. We have shared examples of the innovation and creative approached we found in our review of urgent and emergency services. This will be followed by a full report shortly.

Today, we have published our report about people’s experiences of do not attempt cardiopulmonary resuscitation (DNACPR) decisions during the pandemic. You can read the findings and recommendations in full on our website.

Throughout the pandemic, our approach has been informed by feedback and intelligence. This has come from stakeholders, providers and the public, and we’d like to thank you for the contributions that have helped develop appropriate regulation during this time.

Thank you again for all the work you are doing and keep safe.

Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care