The “important wider role” of nurses in GP practices has been underlined by the Care Quality Commission in its annual assessment of services, which also found most practices providing good care.
The regulator noted the involvement of nurses when its inspectors had witnessed safety improvements in practices with “good” ratings, adding that the shifting of care away from hospitals had put more emphasis on their role in primary care.
“Nurses have an important wider role in general practice care delivery”
In its 2015-16 State of Care report, published today, the CQC indicated the vast majority of GP practices in England were providing good care, but 13% required improvements.
The CQC said the findings were based on inspections of around half – or 4,511 – of GP practices in the country and provided the “best picture yet” of care in this setting.
The regulator is still part way through its assessments of all 8,000 GP practices, following the introduction of its tougher inspection system in 2014.
Today’s report, based on data up until the end of July, revealed 87% of practices were rated “good” and 4% were “outstanding”. But 10% were rated as “requires improvement” and 3% were assessed as “inadequate”.
The CQC said it still had concerns about the care being provided in some places, noting around 800,000 people were registered to practices that had been rated “inadequate” for safety.
Problems found in GP practices included poor medicine management – such as checks on storage conditions and expiry dates, correct administration, and appropriate audit trails and prescription logs.
In addition, clinical waste was sometimes not stored correctly or disposed in the right way, regular equipment checking and servicing was not always carried out, and safeguarding training for staff was sometimes not in place.
Meanwhile, health and safety incidents were regularly not recorded, with no action taken to prevent them happening again, and equipment and training for medical emergencies was often incomplete, said the report.
However, in the practices rated as good or outstanding for safety, the CQC said its inspectors found “a culture of, and proactive approach to, anticipating and managing risks to patients”.
Learning from problems was also shared “not only within the practice and following a thorough and open investigation, but also in the local health community”, the regulator noted.
“Nurses are sometimes involved in such safety improvements, and they have an important wider role in general practice care delivery,” said the CQC in its report.
“Policy for many years has been to shift care from hospitals to general practice, and this puts greater emphasis on the nursing role in general practice,” ir said.
“The skill mix in general practice increasingly includes healthcare assistants, practice nurses, advanced nurse practitioners and physician associates who are involved in the decision-making for the practice,” it added.
The CQC’s annual report also highlighted trends in social care, acute care and mental health settings.