CQC matters: Regulating the safe and effective use of medicines Sarah Billington Head of Medicines Optimisation October 2016 1 1

About CQC: our purpose The Care Quality Commission is the independent regulator of health and adult social care in England. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. Strategy Slides - 24 May 2016 - MASTER

England’s population is 53m Scope of CQC’s remit Hospitals and clinics 245 NHS trusts 1,500 independents Ambulances 10 NHS trusts 250 independents Care homes and domiciliary care 12,500 providers 25,500 care homes 1.75 million people use adult social care 11 million NHS and 1.6 million independent inpatients 22 million dental patients per year (15m NHS, 7m private) Primary medical services 9,000 providers Primary dental care 8,000 providers England’s population is 53m

The Medicines Team

Dispensing practices - summary Around 1,100 general practices registered with us have been identified as ‘dispensing practices’* We have so far rated around 700 of these (out of 4,800+ practices inspected and rated to 1 September 2016) Dispensing practices have received the full range of ratings from inadequate through to outstanding, in broadly similar proportions to other practices. * Numbers are approximate because CQC does not hold data on dispensing practice status, and the data has been matched from other sources

Overall ratings

Ratings by Key Question for dispensing and non-dispensing GPs

Inadequate and requires improvement: themes Across 11 dispensing practices rated ‘inadequate’ and 52 rated ‘requires improvement’, requirement notices and enforcement have been applied covering issues such as: Unsafe storage of medicines Insecure storage of blank prescription forms Lack of systems to ensure safe disposal of patient prescribed medicines Inadequate processes for managing medicine alerts Insufficient training for dispensary staff Inadequate systems for assessing risk of supplying medicines to patients from external locations Health and safety of the general dispensary environment Failure to follow procedures in line with current guidance and legislation on storage, disposal, dispensing and administration of medicines Failure to ensure staff administering vaccines were trained or authorised to do so

Ted’s talk The impact on patients of differences in services

Meet Ted

Ted’s experience of a service Requiring Improvement

Ted’s experience of a service Requiring Improvement

Ted’s experience of a service Requiring Improvement

Ted’s experience of a service Requiring Improvement

Ted’s experience of a service Requiring Improvement

Meet Ted

Ted’s experience of an Outstanding service

Ted’s experience of an Outstanding service

Ted’s experience of an Outstanding service

Ted’s experience of an Outstanding service

Ted’s experience of an Outstanding service

Ted’s experience of an Outstanding service A systematic approach was taken to working with other organisations to improve care and outcomes A comprehensive understanding of the performance of the practice was maintained

Helpful resources for practices Make sure you’ve read our provider handbook, and understand the key lines of enquiry our inspectors will focus on Read our mythbusters for tips and further guidance Read our outstanding practice web tool kit and consider what would make care for people who use your services outstanding Read our ‘What to expect from an inspection’ and case studies to understand what an inspection looks and feels like Look through some ‘Examples of outstanding practice for GPs’. Visit: www.cqc.org.uk/GPProvider 23

What to expect from an inspection Two weeks before we inspect Letter will be sent unless we are responding to concerns We’ll ask for some information in advance Your inspector will be in touch to discuss with you what will happen on the day We will send you a set of comment cards that your patients can complete to tell us their views before we inspect On the day We’ll ask you to give us a short presentation telling us what is good about your practice and the care it delivers We want to talk to staff and patients to find out more We’ll want to see evidence of a variety of things and we will need a room to go through this We will follow the key questions and the key lines of enquiry 24

Feedback and the report After the inspection We’ll give you informal feedback and identify any immediate concerns straight away We’ll write up our report and send to you for factual checking We’ll quality assure your report by looking at it with other reports to ensure consistency of judgement Publish the report on our website If your report is outstanding or inadequate, we will send out a press release about it

Find all of the above and more at: www.cqc.org.uk/GPProvider Find out more Read the monthly bulletin for primary care providers Sent to all providers and registered managers, or sign up through our website Join our provider and public online communities Visit our new guidance page for GP practices www.cqc.guidance for GP practices Find all of the above and more at: www.cqc.org.uk/GPProvider

www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm Thank you 27