Should CQC inspections be replaced with group learning sessions?

A proposition to substitute CQC inspections with group learning sessions has been made by GP Professor Clare Gerada. The proposition was made in consideration of the amount of time spent on ‘compulsory’ training sessions, that have little bearing on GP’s day to day work and continuing professional development, to satisfy CQC requirements.  It is an interesting proposal which seems to comply with CQC’s agenda of working more closely with providers to help them improve.

The argument for the proposition has at its heart the best interests of providers and improving patient care. Professor Gerada uses the example of the struggling provider forced to employ a large proportion of locum staff for whatever reason who is failing to meet regulatory requirements.  She states she doesn’t see the merits of CQC merely identifying the failing which the provider is well aware of within an inspection framework setting; and suggests it would be preferable if instead the provider was encouraged to overcome its failings. It should be noted that the proposal was targeted at GPs in consideration of their high success rate with CQC inspections; but the principle holds equal application across the health and social care sector. She does not advocate the complete abolition of inspection activity but instead greatly reducing the level of CQC activity.  She suggests that the resources used to fund inspection work should instead be offered to providers to attend group learning sessions with peers within the community.

It is a novel idea which certainly shouldn’t be dismissed out of hand.  There are merits associated with working in a collegiate environment which focuses on improvement and where providers accept their failings and are supported to improve.  This seems to be the case for NHS Trusts in special measures where they are supported by a high performing partner trust to improve, and is certainly something which would bear fruit if rolled out across the health and social care environment.  Returning to the proposition, I am fairly confident that CQC will state that group learning sessions are possible and actively encouraged in order to help providers learn from and adopt best practice. However, the idea is highly unlikely to replace any formal inspection process, particularly in the near future.  Possibly the strongest argument against the regulator blurring the lines between critical judge and supportive friend is that this approach could allow underperforming services to avoid being held properly to account.

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