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CQC and the GP Practice - Learning Lessons from the State of Care Report

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In December, the CQC released its 2015/16 State of Care report. It highlighted the good care being given in increasingly challenging circumstances. It also cast doubt on whether improvement is sustainable, noting some deterioration in quality and providers struggling to upgrade from 'requires improvement'.

A big difference between quality of care and quality of leadership

The State of Care report looks at the provision of care in the community with a 'life stages' approach. This enables the GP practice to lead patient care through life stages such as:

  • Neonatal care
  • Transition of care of children to adult services
  • Diabetes care in the community
  • Mental health care
  • Integrated care for older people
  • End-of-life care

While it highlights that 92% of services achieved a good or outstanding quality of care rating, it is critical of the “striking difference between the key question about caring and the comparatively lower performance of safe and well-led. Indeed, it is in the leadership of practice and community services that the greatest number of practices fall down. Only 71% are considered as being well-led.

The report includes examples of GP practices that have shown improvement and how they have initiated and sustained that improvement.

Four factors of improvement in the GP practice

While the CQC can play a part in improvement by enforcement measures, it is clear that truly sustainable change comes from within. This requires leadership that creates a positive culture. Leaders have to be visible, and promote positive change through openness and honesty. Inherent to this is that employees must feel supported and listened to, with the need for change clearly communicated.

The four factors that drive this are:

1. A clear vision

Vision is what compels your people to change. Being able to communicate it within a few minutes is a challenge that must be overcome. Vision will prove the motivator for change and improvement.

2. Destroy complacency

Complacency destroys the will to change, so must be destroyed itself. Complacency sets in when people are simply going through the motions, or are afraid of change. Challenge people to assess their roles and how they do things. Create a culture which is open to criticism and honest about the need for change.

3. Be the example of change

Leaders must be examples of the new culture and behaviours required. They have to be visible and have vision and energy. Inspirational leadership can come from within, or from a new hire specifically taken on to promote change.

4. Collaboration with other care providers

Seek support from other care providers to identify improvements needed, and offer help in making changes.

How are you making improvements?

When things go wrong, it's important to learn lessons and improve. While problems with staffing are a concern, especially for the safety of patients, a well-led practice can instigate change that leads directly to improvement of care and services provided.

An area in which practice managers can help drive change is by ensuring that systems, processes and procedures:

  • Help plan staffing and deliver training
  • Manage safeguarding issues and care plans
  • Strengthen governance and promote transparency

What is your practice doing to improve and learn lessons? Are there leadership strategies or methods you employ that others may find enlightening? Drop us a line and tell us your thoughts. Sharing your leadership strategies could help your fellow practices make the improvements you have.