This article relates to the CQC key questions: Is your practice safe? Is your practice effective? and Is your practice well-led?
To provide safe and effective care, practices need to ensure that all of their staff have the appropriate training, induction and access to accurate information that will allow them to safely and effectively manage patients.
Practice induction packs are a good way to communicate policies and procedures to practice staff to ensure they are effectively implemented.
When we inspect, we look at the practice’s arrangements for ensuring its policies and procedures are communicated to staff and implemented effectively. As part of key line of enquiry (KLOE) S3 we look at whether the systems, processes and practices to keep people safe are identified, put in place and communicated to staff. We also look at the arrangements for supporting staff to deliver effective care and treatment and training.
Safe, effective patient management in primary care is very complex. It requires a series of seemingly simple steps and often involves different members of the practice team.
Securely linking these steps together with good information management is vital for a safe patient journey.
Practices should have clear, regularly reviewed practice policies and procedures in line with the regulations. Key to their safe and effective implementation is how well they are communicated to staff. Practices need to demonstrate that all staff both understand and are trained in practice procedures, and that all staff are regularly updated and, ideally, have easy access to refer to this information in their daily working lives.
Clinicians or staff who are unfamiliar with the practice – such as new staff, staff in training or locum nurses and GPs – may be especially prone to error caused by lack of access to this information. Practices have a responsibility to mitigate this risk by equipping all staff to work safely and effectively. A centralised practice induction pack can be a valuable tool for staff and clinicians who may not be completely familiar or up to date with practice processes.
Practices should consider the format of their induction pack and how this supports safe and effective care. For example, unindexed paper versions and bulging folders are not effective, as they can’t easily be searched and used at the point of need. When a practice uses their intranet, they should consider whether it is transparent and usable for staff who are not familiar with the practice or the way the intranet is structured.
Locally generated sources of pathways and guidelines
Locally generated sources of information and guidance, such as CCG or federation websites, are useful tools in themselves but are not a replacement for a standardised practice induction pack. A safe, effective patient journey through a local pathway will first involve many steps within a practice to ensure a safe referral and these practice-specific steps will usually not be included in a locally generated pathway.
Key features of a good practice induction pack
- Easy-to-search format with familiar navigability, so that clinicians and staff can access essential information at the point of need, even if they are unfamiliar with that practice.
- Regularly reviewed and easily updated by all relevant team members.
- To ensure safety, as a minimum the pack should contain frequently-used or safety-critical items. Packs that promote maximum effectiveness and efficiency as well as safety will contain a more comprehensive range of items.
Further information on practice induction packs
The National Association of Sessional GPs (NASGP) is an organisation that supports locum and sessional GPs to improve patient care. An example of a practice induction pack is the NASGP online Standardised Practice Induction Pack (Spip).
The NASGP describes the tool as having the following features:
- Accessible by as many staff as deemed necessary by the practice.
- Able to search and navigate for information at the point of need, standardised format means that locums will be become familiar with where to find information in other practices too.
- The practice adds relevant information in response to questions from experienced locum GPs so you know what they need to know to work safely. The comprehensive nature of Spip makes it useful to the whole practice team as an information management tool.
- Centrally updatable, so any policy or service information changes are available to all users.
- A messaging function allows for sharing knowledge and means that users can leave feedback about services and procedures in real time to the practice management, allowing monitoring of the quality and effectiveness of practice processes and other services.
The CQC does not require GP practices to use a specific tool.
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection