GP Surgeries: Welcome

Welcome

Welcome to the QCS General Practitioner Management page, where we will take you through a management system designed to not only help you meet CQC compliance, but to also ensure that you have direction in meeting the needs of all your practice patients. As with all QCS management systems you can expect to find support when you require it and continuous development, so that the latest learning is incorporated into new policies by our expert contributors.

About the System

The overall aim of the General Practitioner management system is to take each key area of Practice Management and then distil it into all the policies and procedures you’ll ever need to manage your surgery efficiently and achieve CQC compliance. Whilst our predominant focus is always on CQC compliance, we aim to assist you via our management system, to run your practice as effectively as possible. Online and in paper format, via our easy to use hardcopy folders, we provide continuous updates so that you are kept abreast of any important changes both within the regulated environment and within best practice. In an era of bureaucracy and red-tape, QCS strives to make compliance activity quicker, smarter and simpler.

History

The QCS System was created in the late 1980s, when it was initially a paper packet of core policies and procedures. As most adult social care professionals will recognise, the regulation of this sector has increased immensely since that time, with standards improved considerably. Consequently the QCS product has evolved over the years to reflect the changes in regulatory requirements and the different needs of each care service. We work very closely with our customers, or if there is a document you need that you can’t find in the system, or you feel would make a great addition to it, then get in touch with our Customer Care team and they will help you to either locate it, or they will work with one of our expert contributors to have it created.

Making the system easily navigable and reflective of the latest changes is what we do best. In the second half of 2011 alone, we’ve added 2 major toolkits and half a dozen new features to the online system to make it even more interactive for you. A more interactive system means you have more tools available to stay compliant, whether it’s assigning reading lists, uploading your own customized documents or reading alerts about important policy changes which must be implemented in your care service. We have also extended the service to provide management systems to the dental profession and also to general practitioners. Shortly we will providing compliance solutions to the Early Years sector as well as introducing variations on our GP management system.

General Practitioner

As from the 1st April 2013 all providers of primary medical services including GPs, are required under the Health and Social Care Act 2008 to not only be registered with the Care Quality Commission, but to also comply with the provisions of the Act ensuring that the “Essential Standards of Quality and Safety” are always being complied with.

Unlike the adult social care profession who have been used to CQC regulation (and its predecessors) for some time now, we recognise that this change will be challenging for the medical profession, who are also scrutinised by other regulatory bodies. To assist with compliance against the essential standards, we have created a GP management system which takes the onerous nature out of what is required of the practice manager or the senior partner.

With over 200 policies and procedures in place already, we have provided GP practices with the essential building blocks for meeting CQC standards. As learning is gathered from the registration and regulatory requirements of the CQC, we will be amending policies and introducing new ones to ensure that your compliance requirements are being met. It is a challenging time for medical professionals, but Quality Compliance Systems is well placed to ensure that compliance requirements are always being evaluated for the latest changes.

Our GP management is supported by a leading practice management expert who is continually reviewing best practice, plus any regulatory changes. You can also confidently expect to see further development still to our guide to clinical governance as well as a mock inspection toolkit to help you get prepared for the inevitable inspection. Although we provide similar support to the adult social care profession and to dentists, we expect the GP management system to grow rapidly as we offer specialisms in out-of-hours services, walk-in centres and urgent care centres to name but three planned innovations.

The CQC

The Care Quality Commission is the regulatory body in England for Health and Adult Social Care Professionals. The Health and Social Care Act 2008 came into force on the 1st October 2010, requiring all existing and new English Care Providers to comply with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009. For General Practitioners, registration with the CQC and adherence to their outcomes will come into effect as of the 1st April 2013. If you provide an out-of-hours service, then you will need to register by the 1st April 2012.

The CQC’s business plan states their five priorities as:

1. Making Sure that care is centred on people’s needs and protects their rights
2. Championing joined-up care
3. Acting swiftly to help eliminate poor quality care
4. Promoting high quality care
5. Regulating effectively, in partnership

In order to register, the Primary Medical Care Provider (GPs) must complete a declaration as to whether their service meets the 16 CQC Outcomes of the ‘Essential standards of Quality and Safety’ which are required by the new Regulations.

Explaining Regulated Activities

The Health and Social Care Act (Regulated Activities) Regulation 2010 details 15 regulated activities, from which a Primary Medical Care Provider must select those regulated activities which are being carried on.

It is important that a GP Practice identifies those regulated activities which it carries out, as there may be variations from one practice to another. As a guide only, the CQC have advised that it is likely to contain (although not be limited to) the following regulated activities:

1. Treatment of disease, disorder or injury
2. Surgical procedures
3. Diagnostic and screening procedures
4. Family planning services. The CQC however, have advised that this only applies to the insertion or removal of intrauterine contraceptive devices (IUCDs).
5. Maternity and midwifery services

Should there be any possibility that a Primary Medical Care Provider may need to register for further regulated activities, and you are unsure which, then advice can be sought from the CQC under their “scope of registration”

GP out-of-hours service

Guidance has been issued to assist GP practices with determining if they provide an out-of-hours service as specified by the CQC, and if they should therefore register by the 1st April 2012.

• Personal Medical Services (PMS) or Alternative Provider Medical Services (APMS) contracts to look after patients who are not restricted to a list of registered patients.
• Out-of-hours services provided under a sub-contract to a General Medical Services (GMS), PMS or APMS provider, for example subcontracted from a GP practice.

An out-of-hours care is generally provided after 6.30pm and before 8am during weekdays, and all day at weekends and on bank holidays.

Some providers may hold contracts (mainly APMS) which specify different period as “out-of-hours”. These providers will need to register by April 2012.

Exceptions to this (subject to the revised regulations being passed by Parliament) are:

• GP practices that directly provide out-of-hours services solely to their own registered patients or temporary residents (e.g. those GP practices who have not ‘opted out’). However, a co-operative of GPs who cover each other’s patients’ out-of-hours service would need to register by April 2012.
• Services provided in the out-of-hours period, or run in the evenings or at weekends, under the extended hours access arrangements.
• Services which run in the evening or at weekends as part of their contracted core hours. For example a GP-led health centre with an APMS contract which opens 8am to 8pm and at weekends would not need to register by April 2012.

If you do provide an out-of-hours service and need to register in 2012, you will need to register for all of your primary care services and all of your regulated activities for which you are not already registered at that time. For example, this will include any walk-in centres, urgent care centres or GP practices which are run by you as a provider.

As with the guidance above, the CQC have advised that they anticipate the following regulated activities to be carried on by GPs out-of-hours service, but it may not necessarily be limited to these activities:

1. Treatment of disease, disorder or injury
2. Transport services, triage and medical advice provided remotely.
3. Diagnostics and screening procedures.

Registering with the CQC

Registering with the CQC need not be daunting when you are a QCS customer. We will help you through the process by answering your questions when completing the lengthy application forms for Registered Providers and Registered Managers and most importantly, by providing you with all the policies and procedures you need to achieve CQC Compliance

In order to register, the Provider must complete a declaration as to whether their service meets the 16 CQC Outcomes of the ‘Essential standards of Quality and Safety’ which are required by the new Regulations.

Our System Provides All CQC Requirements:

• The policies which must be in place
• The procedures which must be in place
• In-depth policy and process instructions/information
• The other documentation which the CQC (previously CSCI) require to be in place

Types of Service Providers

There are three types of service provider: Organisations; Individuals; and Partnerships. When completing the registration application you need to define which of the three best describes your business. For ease of reference, Registered Companies, Limited Liability Partnerships (LLP), charities and other corporate bodies will be defined as “organisations”. “Individuals” are those GPs who operate in what is often referred to as single-handed practices/sole traders. In other words if practice is owned by a single-handed contractor and then you should register as an individual.

If you carry on any regulated activities as a partnership, it is the partnership (including all the partners) that must register. The partnership as a whole, as well as each individual partner, is responsible for ensuring that the regulated activities provided meet the essential standards.

Therefore, you should only register as a partnership if you have made arrangements for all partners to accept joint and several liabilities for the way the activity is carried on, and each individual partner has agreed to this. It is expected that most GP practices will need to register as partnerships.

A partnership that doesn’t have these arrangements in place, such as one that is limited only to arrangements for expense sharing, should not register as a partnership. In this case, if each person is carrying on regulated activities as an individual without shared liability, they will need to register separately.

For legal reasons, a limited liability partnership (LLP) should register as an organisation, not as a partnership.