Publish date: 7 June 2023
Following the recent Care Quality Commission (CQC) inspection, our Quality Review Visit (QRV) process is undergoing changes to make sure QRVs continue to fully assist us to improve the quality of care we provide to our patients, service users and their families. These changes will help us prepare better for future inspections.
We’re introducing an ‘Operational Excellence’ framework that will support greater clarity on operational priorities and expectations, whilst making sure team leaders have the right tools and support to deliver their services efficiently and effectively. We will update you on these developments as soon as they are completed.
Initially we’re piloting changes to the Safe domain and have added three new areas of enquiry:
- Evidence of patient harm: Radar reports of moderate or severe harm to patients/service users can result in a ‘Requires Improvement’ or ‘Needs Support’ score (Mitigating factors can be the context and/or the numbers/cause of harm).
- Excessive caseloads: can result in a ‘Requires Improvement’ or ‘Needs Support’ score, particularly if there is no evidence of rigorous and systematic case load management.
- Waiting lists: excessive waiting times can result in a ‘Requires Improvement’ or ‘Needs Support’ score (mitigating factors can include a waiting list management approach that includes a clinical harm review assessment tool).
We have also added new, additional scoring criteria for the Safe domain which will result in more focussed scrutiny. The criteria are summarised below:
- If there are between three to five areas within Safe marked as ‘Requires Improvement’, this will result in an ‘Requires Improvement’ for the Safe domain and a capping of the overall rating of ‘Requires Improvement’ will be placed on the whole report
- Any six plus areas of enquiry within the Safe domain marked as ‘Requires Improvement’ will result in a ‘Needs Support’ score for the Safe domain and a capping of the overall rating of ‘Requires Improvement’ will be placed on the whole report.
Alongside these changes, we’re introducing unannounced QRVs. These visits will help us to assist teams to prepare and increase their confidence for unplanned CQC or system wide inspections.
We understand that these changes may result in some teams moving from previously Good/Good Plus QRV ratings to either ‘Requires Improvement’ or’ Needs Support’. However, we hope that this revised and refreshed focus for our QRVs will enable us all to have a focus on ensuring we make necessary, timely improvements to our services, whilst recognising some of the solutions will be within the team, the Trust or in the wider commissioning arena.
Our first area of focus is the safe domain as we received a ‘Requires Improvement’ score. However, changes to our QRV process will continue to evolve and include other domains to help us to continuously improve across all areas of our services for our patients and service users.
As a result of these changes, there will be initial delays in publishing any recent and planned QRV reports as we need to alter the algorithms embedded in the SharePoint system. I would ask for your support, understanding and patience whilst teams work together behind the scenes to make these changes possible.
In making these changes to our QRV process, we’re confident that we will be able to support every Mersey Care clinical team to become the very best at what they do, and we will make every effort to ensure that we continue to work with you to help you support and develop your services.