For many Practice Managers and Registered Managers, CQC inspections have always brought a level of apprehension — but recent inspections have made one thing increasingly clear: alignment matters. Not just having a policy. Not just having a protocol. But demonstrating that your policies and protocols match actual practice — and that they are applied consistently across your team.
The CQC’s Sharper Lens: From Policy to Practice
Historically, inspections may have focused heavily on whether your policies existed, were up to date, and covered the relevant legal and clinical frameworks. But today, inspectors are diving much deeper — asking staff directly:
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How do you follow this policy?
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Can you explain your process for… ?
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Show me how this happens in practice.
The Care Quality Commission are rightly moving towards ensuring that what’s written on paper is not only compliant, but is truly embedded in the day-to-day running of the practice. This reflects the growing importance placed on governance in action.
Where Many Practices Get Caught Out
Often, we see that practices:
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Have SOPs and policies that are compliant — but never fully embedded.
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Have differing approaches between team members depending on experience or habit.
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Find that informal workarounds or historic ways of working have drifted away from agreed protocols.
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Experience confusion when cross-covering staff step into unfamiliar processes.
In these situations, what emerges is variation by default, not by design — something inspectors are increasingly picking up during staff interviews, patient records sampling, and safety walkthroughs.
The Opportunity Hidden in SOP Reviews
Many of you may be reviewing your policies and SOPs at the moment, whether as part of scheduled governance cycles, or prompted by CQC preparation.
This is the perfect time to take a more strategic approach:
Don’t just review your SOPs — use this opportunity to define what best practice looks like across your practice, and even across your Primary Care Network.
By coming together across practices within a PCN, managers and partners can build aligned SOPs that:
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Reflect the best of everyone’s experience.
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Create consistency for patients, staff and regulators.
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Reduce variation that creates clinical or administrative risk.
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Support cross-cover and workforce flexibility.
Standardisation Where Possible — Flexibility Where Needed
Of course, some differences will always exist — and should exist — based on:
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Premises layouts (for example: emergency evacuation plans)
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Skill mix variations (who is trained to do what, locally)
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Local pathways and population health needs
But these adaptations should be the exception rather than the default. They should be captured within aligned SOPs and easily explained during inspection.
What the CQC are less likely to accept moving forward is the old fallback phrase of:
“This is just how we’ve always done it.”
When policies and protocols vary, the burden of explanation becomes higher. By aligning SOPs across your organisation or PCN, you reduce unnecessary complexity, strengthen your governance, and create a clear narrative for inspection.
Aligning Now: A Leadership Mindset
This is not simply a compliance task — it’s a leadership opportunity. Aligned policies:
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Strengthen your Well-led domain.
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Improve induction, training, and ongoing competency.
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Simplify annual reviews and policy updates.
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Support consistency when staff move across sites.
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Build confidence ahead of your next inspection.
CQC Are Watching — And We Are Supporting
The CQC will continue to evolve how they assess this area — but alignment will remain a core theme.
As inspectors increasingly assess how policy is implemented at every level, practices that have taken time to embed and align will stand out as safer, better led, and more resilient.
Join us over on the CQC Confidence Community to continue the conversation and learn about the Harmony 8 Step Framework for CQC confidence. club.hcqc.co.uk