Guidance & Templates
CQC Support
Practical guidance on CQC registration, inspection and ongoing compliance for practices across Oldham, Tameside and Glossop.
All GP practices providing regulated activities in England must be registered with the Care Quality Commission (CQC) and meet the fundamental standards set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Practices that get good governance right day to day are usually inspection-ready without extra effort. This page explains what CQC looks at, what is changing, and how the LMC can help, including if things go wrong.
What's changing at CQC (2026)
- The Single Assessment Framework (SAF) is still in force. Practices are currently assessed against the five key questions and the quality statements, until CQC confirms the new framework has gone live.
- A new primary care framework is coming. Following the Dash review and the Better regulation, better care consultation, CQC is replacing the single framework with four sector-specific frameworks, one of which covers primary care and community services. Under the new framework: quality statements will be replaced by key lines of enquiry (KLOEs); rating characteristics describing what good and outstanding look like will return; and the numerical scoring system will be removed, with ratings based on professional judgement. Implementation is expected from late 2026.
- The five key questions and four-point rating scale are staying. Ratings will still be outstanding, good, requires improvement or inadequate.
Which practices are being inspected?
CQC has been working through a large backlog. For primary care, it is prioritising:
- Follow-up assessments after enforcement action
- Practices whose rating is more than seven years old
- Services that have been registered for a year or more but not yet assessed
- Practices where information or concerns suggest risk
CQC is also running a Returning to Good and Outstanding programme. These are shorter, focused assessments of lower-risk practices rated good or outstanding whose last report was published between 2017 and 2022. They concentrate on non-clinical quality statements, which in practice means governance, leadership, staffing and processes. The practice manager is likely to be central to this type of inspection, so make sure they are fully prepared.
Check your date.
If your last full inspection report was published before 2020, assume an assessment could come at short notice and review your evidence now.
The five key questions: what CQC looks for in general practice
| Key question | Typical evidence in general practice |
|---|---|
| Safe | Significant events and learning, patient safety alerts, safeguarding, medicines management (including high-risk drug monitoring and repeat prescribing), IPC, recruitment checks, emergency medicines and equipment |
| Effective | Clinical searches and records reviews, long-term condition reviews, clinical audit and quality improvement, clinical supervision of non-GP clinicians, staff competence and training |
| Caring | GP Patient Survey, Friends and Family Test, carers' register and support, privacy and dignity, how staff talk about patients |
| Responsive | Access arrangements, how the practice manages demand, online consultation, reasonable adjustments, complaints handling and learning, and care for people in vulnerable circumstances |
| Well-led | Leadership and vision, governance and meeting structure, risk management, staff voice and Freedom to Speak Up, staff wellbeing, and partnership working with the PCN, ICB and neighbourhood |
Clinical searches matter.
For many practices, the most significant findings come from CQC's remote clinical searches and records reviews, not from policies. These cover areas such as: high-risk drug monitoring (e.g. DMARDs, lithium, warfarin/DOACs); patients with potential missed diagnoses (e.g. CKD, diabetes); asthma patients prescribed two or more rescue steroid courses; medication reviews; and safety alert actions (e.g. valproate). Run these searches yourself regularly and act on what you find.
Staying inspection-ready
Governance
- A clear structure showing who leads on what: safeguarding, IPC, information governance, significant events, complaints, prescribing and health and safety
- Regular partner, clinical and whole-team meetings, with minutes that show decisions, actions and learning
- A risk register that is actually reviewed, and a single action log to track progress
- A business continuity plan that has been tested
Patient safety and learning
- Record significant events and near misses, investigate them, share the learning and check the actions have worked
- Report patient safety events through the NHS Learn from Patient Safety Events (LFPSE) service, which replaced NRLS
- Have a system for receiving, acting on and recording patient safety alerts (MHRA and NatPSA), including retrospective searches
Medicines
- Monitoring of high-risk drugs, and structured medication reviews
- Emergency medicines and oxygen, with a documented risk assessment for anything you choose not to stock
- Vaccine cold chain and fridge temperature records
- Prescription stationery security
- Clear PGD and PSD arrangements
Safeguarding
- Named adult and child safeguarding leads
- Training at the correct intercollegiate level for each role
- Registers and alerts on the clinical system
- Regular safeguarding meetings or liaison with health visitors and other agencies
Infection prevention and control
- A named IPC lead and an annual IPC audit with an action plan
- Cleaning schedules, and clinical waste and sharps management
- Legionella risk assessment where required
- Staff immunisation records
Workforce
- Complete recruitment files: identity, right to work, references, DBS, registration, indemnity and immunisation status (Regulation 19)
- Induction, appraisal and a training matrix showing compliance
- Oliver McGowan training on learning disability and autism, which is a legal requirement for staff of CQC-registered providers
- Documented clinical supervision and competency checks for ARRS and non-GP clinicians, including locums
Policies
- Policies should be current, version-controlled, relevant to your practice, and known by staff. Inspectors are more interested in whether staff can explain what they would do than in how many policies you hold. Quality beats quantity.
See also our Workforce & Employment page for recruitment checks and staff management guidance.
Registration changes: an area where practices often slip up
Many practices only think about CQC registration when they first register. However, changes to the partnership or services must be notified to CQC. In some cases a formal application is needed. This includes:
- Partners joining or leaving: depending on your provider type, a change to a partnership can require a new registration or a variation. Start early, as it can take weeks
- A change of registered manager: this needs an application
- Mergers, new branch sites or closed sites, and adding or removing regulated activities
- 24-hour retirement and similar pension arrangements, which can affect both the NHS contract and the CQC registration
Tell the LMC early.
Tell the LMC early if your practice is planning a partnership change, merger or new site. The contract variation with the ICB and the CQC registration change need to be aligned, and getting the order wrong causes delays.
Key legal duties practices sometimes forget
- Duty of candour (Regulation 20): when a notifiable safety incident occurs, you must be open with the patient, apologise, and follow up in writing
- Statutory notifications: certain events must be reported to CQC, including deaths of patients in specified circumstances, serious injuries, abuse or allegations of abuse, events that stop the service running safely, and police involvement
- Display of ratings: your current CQC rating must be displayed at each premises and on your website
- Fit and proper persons (Regulation 5) for partners and directors, and fit and proper persons employed (Regulation 19) for staff
The fundamental standards in full
Registration of practices and PCNs, inspection and enforcement
After an inspection
Factual accuracy
Every practice gets the chance to challenge the factual accuracy of the draft report. Your challenge should:
- Point to the specific part of the report you disagree with
- Provide evidence that shows the position at the time of the inspection
- Meet the deadline, as this window is short
Improvements made after the inspection are not grounds for changing the report. They belong in your action plan.
CQC mythbuster 79 – Factual accuracy for CQC inspection reportsRequires improvement or inadequate
A poor rating is stressful for the whole team, and partners can feel it personally. Contact the LMC as soon as you receive a draft report you are worried about, before you respond to it. We can:
- Help you with factual accuracy comments
- Support you with improvement planning
- Speak to the ICB if contract action follows
- Signpost wellbeing support for partners and staff
Practice teams going through a difficult inspection can access confidential support from NHS Practitioner Health (0300 0303 300). NHS Practitioner Health
Frequently asked questions
Key resources
CQC's own guidance on common issues: emergency medicines, chaperones, locums, training, safeguarding and more. The single most useful practical resource.
Learn from Patient Safety Events and the Patient Safety Incident Response Framework
Immunisation and infection guidance
Quality improvement and safeguarding resources
Need help?
West Pennine LMC supports practices before, during and after CQC inspections. This includes help with registration changes, factual accuracy responses, improvement plans and any contract implications with the ICB. All contact is confidential.
Good CQC outcomes are rarely about producing more paperwork. They come from strong leadership, governance that works, visible learning and a well-supported team. This page gives general guidance only. Always check CQC's current published guidance. Last reviewed: September 2026.