Case Study - Special Measures

GP practice in “special measures” – a case study

Turning the negatives into positives after a challenging CQC report

The McLaren Perry team were called in by this GP practice after a highly critical CQC report placed it in ‘Special Measures’, with the regulator demanding a rapid plan of action and improvement.

The challenge

The CQC report on this three partner, 9000 patient GP Practice left it facing potential closure and a CQC deadline of one month for a comprehensive action plan. Although patient and clinical care were generally good, the regulator highlighted a list of issues requiring urgent resolution including:

  • Poor leadership and Practice Management
  • Lack of governance
  • Poor or non-existent systems and processes
  • Good patient care but no supporting evidence
  • Mandatory staff training incomplete
  • Poor cold chain management
  • No infection control processes
  • Lack of HR records
The process

With staff morale understandably low and a CQC deadline looming, McLaren Perry firstly set about reassuring the partners and staff that a turnaround was possible.  The team then prioritised the issues raised by the CQC and undertook the following:

Analysis

  • A due diligence exercise and full practice review, followed by a full report to the Partners with clear recommendations
  • Creation of a measurable three-month action plan
  • Preparation for a CQC ‘pre-visit’ at the end of three months and full inspection at six months
  • Staffing levels, skills gap and disciplinary analysis

Communication

  • McLaren Perry took on the role of communicators for the practice, liaising directly with the CQC, and managing the entire inspection and partner presentation process.
  • Communicated with staff and, where required, took a robust approach to staff behaviour
  • Conducted staff satisfaction surveys and facilitated meetings to share ideas and issues.

Implementation

  • A full action plan, created ahead of deadline
  • McLaren Perry managed all aspects of HR management including creating staff files, a short and long-term structure, training and development of policies and procedures
  • An experienced interim Practice Manager seconded in to support the management team
  • Full vaccine management and infection control processes implemented
  • A comprehensive governance structure introduced and regularly monitored
  • Staff training process and procedures implemented and communicated
The outcomes

McLaren Perry’s significant Primary Care experience ensured a rapid change in both culture and working practices at the Practice. Within the first month the CQC had received a clear and measurable action plan. The decision for McLaren Perry to become the Practice’s spokesperson also reduced pressure considerably from the Partners, allowing them to focus on rapid implementation of improvements without affecting the quality of patient care.

Within less than a year, the transformation of the Practice included:

  • The Practice taken out of ‘Special Measures’ within six months, upgraded to ‘Requires Improvement’.
  • Significantly enhanced staff morale with satisfaction surveys showing staff feel “more valued”.
  • Replacement and additional staff, including a practice nurse, recruited with skills that reflect the immediate and future needs of the Practice, including recruitment of a full-time Practice Manager.
  • A measurable governance structure operating under regular monitoring with Partners and the senior team reporting greater self-reliance and confidence in managing the Practice.
  • The relationship with the CQC enhanced and now positive and productive
  • Infection control and cold chain management fully-embedded using best practice policies and processes
  • Robust systems and processes in place for HR, finance, governance and practice management
  • Management reports regularly reviewed by McLaren Perry with recommendations agreed
  • McLaren Perry’s involvement has been reduced from daily to two days per month ongoing.
What our client says

“We asked McLaren Perry to support us through a challenging period in the life the Practice and we were not disappointed. They have been instrumental in helping us overcome a number of significant management challenges after a highly critical CQC inspection.

“Their depth of knowledge and collaborative approach gave the Partners confidence to tackle positively the tasks we faced and they reduced the pressure by using their communication skills and reputation within the healthcare sector. Their combination of strategic vision with an eye for detail has enabled us to create a positive working environment, recruit skilled staff and introduce sustainable performance measures.”
Dr Ramesh, Managing Partner