General practices that are rated as ‘good’ or ‘outstanding’ by the CQC tend to be those that had invested in, and understood the value of, their nursing teams.
The CQC’s own report, The state of care in general practice, 2014-17, published today, found that practices who had invested in larger general practice nursing teams had ‘several advantages’, and were more likely to be practices with higher ratings than those with smaller nursing teams, or those operating with just one practice nurse.
The report states: ‘In a larger team it is easier to develop expertise in specific areas and divide responsibilities that would often be the sole responsibility of a single practice nurse; this can cause practices to perform poorly in the safe key question, for example in the governance systems for monitoring medicines, equipment and infection control.’
It added that while size of a practice did not dictate whether it can provide good quality care, there was a link, as larger practices found it easier to have staff with defined roles. This meant a ‘greater likelihood that there will be well-functioning nursing teams where nurses focus on particular areas, such as diabetes, and junior nurses take on task-oriented roles’.
The CQC also found a growth in the role of nurses providing care for patients with acute conditions, some practices ‘could not always demonstrate sufficient clinical oversight and support for this advanced level of practice’.
The report, published today, aims to set out the findings from the CQC’s first inspection programme, which began back in 2014.
Other findings from the report include:
- The role of the nurse manager was more common in larger practices, and is ‘valuable’ in developing the nursing team with professional support and appraisal
- An ‘inadequate’ rating limited practices from improving because of a perceived poor reputation, and resulted in some struggling to recruit staff
- Patient safety ‘continues to be the poorest’ of the five inspection domains, with 33% of practices rated inadequate or needing improvement on first inspection