Information from our monitoring activity helps to determine the type of inspection and what we will look at.
Types of inspection
Focused
We will continue to carry out focused inspections. This means we will not always consider all 5 key questions on each inspection.
Focused inspections enable us to follow up any potential changes in the quality of care that our monitoring activity has highlighted. These inspections only focus on certain key questions to explore particular aspects of care.
We will usually inspect the safe, effective, responsive and well-led key questions as a minimum. In some inspections, we may also inspect the caring key question if the information we have suggests that the quality of care has changed since the previous inspection. We may change that focus if additional risks emerge during the inspection.
We use focused inspections to update overall ratings.
We will also be undertaking some targeted assessments of the responsive key question. These will usually be carried out without a site visit through email or telephone conversations and we will use them to update the rating for the responsive key question.
In some circumstances, we may need to change the focus of an inspection or assessment. For example, where there are concerns or there have been significant changes to the quality of care provided.
Comprehensive
Comprehensive inspections address all five key questions, and ask is the service safe, effective, caring, responsive and well-led? We will carry out a comprehensive inspection where:
- a service has not yet been inspected
- we identify concerns during a focused inspection
- a service has an overall rating of inadequate or requires improvement.
Follow up
We will inspect when we need to follow up on an area of concern. This could be a concern identified during an inspection that has resulted in enforcement action, or concerns that the public, staff or other stakeholders have raised with us.
These inspections do not usually look at all five key questions. They usually focus only on specific areas indicated by the information that triggers the inspection. Follow up inspections may be unannounced. If we identify concerns during the inspection, we may assess other key questions.
Inspecting GP practices that are working at scale
We recognise that many GP practices are collaborating with other organisations in formal and informal ways. We are developing and testing our approach to inspecting to make sure services provide high-quality care, and that leadership and governance at all levels support this. Our strengthened relationship management and monitoring will help us to understand where collaboration is happening and how this will affect what we inspect. We will reflect any collaborative working in your inspection report.
If your practice is rated as good or outstanding, we will ask you for some contextual information about your links to other practices, federations or networks when we arrange the telephone call to carry out the provider information collection.
Inspecting complex providers
If you deliver services across more than one sector, we try to align our inspections to be more efficient and to make the process simpler for you. For example, some organisations may provide a combination of primary health care services, acute hospital services, mental health care, community health services and ambulance services, and may also run care homes. We will use teams of specialists to inspect each of these services.