The Care Quality Commission will begin inspecting health systems across whole geographical areas from next year, its chief inspector of general practice has said.

In an interview with HSJ, Steve Field said inspectors would also scrutinise the performance of NHS 111 services, as part of an increasingly system-wide approach to inspections in 2015.

“We’re going to start [reviewing] how we look at the system and how joined up it is,” he said.

“This will come in gradually, but we’re going to pilot it just after Christmas.

“We want to [look at] how [it is] linked [to other services] because we’ve heard of great variation in [NHS] 111. It will be about looking at the integration of services, of which 111, when it’s done well, seems to be better for patients, saves appointments and saves money.”

The CQC’s checks of NHS 111 services will be carried out as inspectors examine the performance of GP practices and accident and emergency departments, Professor Field added.

“We’re going to time some of those visits for when we’re looking at A&E departments, and we’ll time our inspections of [NHS] 111 and urgent care so that we do it all together”.

Steve Field

The new whole system approach will be piloted after Christmas, Steve Field said

The work will be led by Ruth Rankine, the deputy chief inspector of general practice.

The new system-wide approach will also examine social care services, with the aim to provide “joined up information” and “empower patients to seek care as appropriate”.

“You might find an area where the A&E department is so overwhelmed because the [NHS] 111 and the out of hours aren’t working,” Professor Field said.

“What we’ve found so far is when they’re joined up, its better.”

He gave the example of Croydon University Hospital, where emergency admissions fell by 50 per cent after an urgent care centre was built next to its A&E.

Professor Field spoke to HSJ as the CQC’s first report into out of hours inspections found “significant” improvements since a 2010 ministerial review highlighted concerns about the quality of provision. Professor Field said there was “some variation” between providers.

Out of hours services would be subject to a similar special measures regime as GP practices when the regulator found examples of inadequate care, he added.

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