Good Vs Outstanding Rating in Primary Care

Imagine you get the CQC report after all your hard work and you have been rated OUSTANDING. You feel after many weeks of pain hard staking labour, that you finally have got your due, or imagine you got a Good instead. You still feel you had done amazing work and maybe it is not fair that you just got a GOOD. Well don’t worry all is not lost. 

Over 20 years and doing many inspections and being a CQC specialist advisor, I can hand on heart say, I prefer a good rating any day. You must be thinking I am mad. But there is method to my madness. The CQC has for some time been doing intermittent telephone inspections to see how you are doing usually 2-3 years after you get a good. If they find that you cannot justify the outstanding rating you will get an inspection. But let’s look at why organisations get an outstanding rating. 

Getting outstanding, is usually when Practices have  done a lot more than what is expected for patient care, and in most instances comes into the bracket of it is not feasible for all surgeries to do. For example, 1 surgery who registered new patients with a Long-Term Condition, had a ltc review on the day of registration. The Rating system is not always the best. You only need to get two areas of outstanding to get outstanding to achieve outstanding rate. I have seen outstanding practices with part of their Key Line of Enquiries rating requires improvement. So, in my eyes a practice which receives in good in all areas is better than an outstanding practice, with requires improvement. I have even seen practices which have been rated outstanding, not have all the areas inspected, and the CQC has said in the Population groups, “Insufficient evidence to rate.” Yet the surgery has been given an outstanding rating, now how is that fair. 

Majority of outstanding ratings were originally back in 2015-2016, and since reinspected have not managed to hold those ratings due to the way CQC have changed the way they do their inspection in 2018, when it became more evidence based. Year upon year the outstanding rating is on a negative trend. With an average of only 47 surgeries being able to get outstanding. 

My advice is do some outstanding piece of work, but it’s better to get a Good rating rather than getting an outstanding, as it is so much harder to retain, and you are putting yourself on the radar of the CQC and CCG.