Understanding the CQC's New Scoring System for GP Practices

Care Quality Commission (CQC) has introduced a new scoring system to provide a more detailed evaluation of GP practices and other healthcare providers. This system assigns percentage scores to each of the five key questions used in CQC assessments:

1. Are services safe? – Ensuring protection from abuse and avoidable harm.
2. Are services effective? – Assessing if care, treatment, and support lead to good outcomes.
3. Are services caring? – Evaluating if staff treat individuals with compassion, kindness, dignity, and respect.
4. Are services responsive? – Determining if services are organized to meet individual needs.
5. Are services well-led? – Reviewing if leadership, management, and governance ensure high-quality care.

How the Scoring System Works

Each of these five key questions is now assigned a percentage score, which corresponds to one of the following rating bands:

• Outstanding: 88% to 100%
• Good: 63% to 87%
• Requires Improvement: 39% to 62%
• Inadequate: 38% or lower

These scores are determined by evaluating multiple quality statements under each key question. For example, under ‘Safe,’ CQC may assess factors like infection prevention and control, safeguarding procedures, and staffing levels. The final score for each key question is derived from evidence across four categories:

1. People’s Experiences – Feedback from patient surveys, complaints, and compliments.
2. Staff and Leadership Feedback – Insights from interviews with staff and management.
3. Observations – Direct inspections of the practice environment.
4. Processes and Documentation – Reviewing policies, procedures, and training records.

Example of How Scores Are Assigned

CQC provides an example of how the scoring system applies in practice. Suppose a GP surgery is being assessed for its infection prevention and control measures. The inspectors will gather evidence from patient feedback, staff interviews, on-site observations, and documentation. Each of these factors contributes to a total score for the relevant quality statement, which then feeds into the overall score for the ‘Safe’ category.

How Quality Statement Scores Determine Key Question Ratings

CQC uses published evidence categories to guide assessments and create individual quality statement scores. These scores are then combined to give an updated view of quality at the key question level.

Example: Combining Quality Statement Scores for the 'Safe' Key Question

Within Safe there are eight quality statements which are; learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risks, safe environments, infection prevention and control, safe and effective staffing, medicines optimisation.  Each can be scored out of 4.  

• 4 for each quality statement where the key question is rated as outstanding
• 3 for each quality statement where the key question is rated as good
• 2 for each quality statement where the key question is rated as requires improvement
• 1 for each quality statement where the key question is rated as inadequate

CQC can use an existing score from a previous inspection or update the score.  

Let us assume that the practice scored 21 for the safe key question.

To calculate a percentage score, the total score (in this case, 21) is divided by the maximum possible score. The maximum score is determined by multiplying the number of quality statements(8) by the highest possible score per statement (4), which equals 32. Using this formula, the percentage score for the ‘Safe’ key question is 65.6%(21 ÷ 32).

Does the New Scoring System Really Matter?

While the introduction of percentage scores offers more transparency, in reality, these scores make very little difference to most practices. The main impact is helping determine whether a practice is performing at the higher or lower end of a category. For example, a practice scoring 85% in ‘Good’ is performing better than one scoring 65%, but both remain in the ‘Good’ category.

Unless a practice is close to moving between rating bands (e.g., from ‘Good’ to ‘Requires Improvement’), the percentage scores do not significantly affect how the CQC rating is perceived by patients, commissioners, or the practice itself.

Final Thoughts

CQC’s new scoring system is designed to provide more granular insight into how healthcare providers perform. However, for most GP practices, the actual impact will be minimal. The key takeaway is that unless your scores place you on the cusp of a rating change, the additional detail is unlikely to alter how your practice is assessed or managed.

If your GP practice is in London an you are looking for help navigating CQC inspections or overall compliance support, MATAR.co.uk offers tailored support services. We specialise in supporting GP practices with all aspects of CQC requirements and readiness.