The eDEC: More Than a Tick-Box – It’s Your Contractual Safety Net

Every year, practices complete the General Practice electronic self-declaration (eDEC).

On paper, it looks like a long list of Yes/No questions.

In reality, it’s much more important than that.

The eDEC is one of the main ways you demonstrate contractual and regulatory compliance to your ICB, NHS England and (indirectly) CQC. At any point, your ICB can come back and say:

“You told us ‘Yes’ to this. Please show us the evidence.”

And that’s the bit many practices feel most uncomfortable about. You know you’re working hard, you know you’re providing safe care – but can you show it?

This blog looks at the revised and new eDEC questions and how to use them to prove compliance, strengthen governance, and build your evidence – even where you need to do that after submitting your declaration.

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eDEC as Evidence of Contract and Regulator Compliance

The eDEC isn’t “just admin”. It sits right at the junction of:

• Your GMS/PMS contract

• NHS England and ICB oversight

• Regulation 17 (Good governance) and wider CQC expectations

• Patient safety and quality improvement

When you tick “Yes” you are effectively saying:

“We are doing this, and we could evidence it if you asked us to.”

Sometimes you already have bullet-proof evidence:

policies, minutes, audits, logs, training records, screenshots – all filed neatly in your governance folders.

Other times, you realise in the process of completing the eDEC that:

• You are doing the right things in practice,

• …but if the ICB or CQC asked, you’d struggle to prove it quickly and cleanly.

That’s where post-declaration evidence-building comes in.

You’re not inventing compliance after the fact.

You’re formalising, documenting and tightening what’s already happening – so that your declaration can stand up to scrutiny.

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Where the New and Revised Questions Are Pointing

The latest changes cluster around a few clear themes:

• Workforce, safeguarding and culture

• Access and online consulting

• Patient communication, charters and safety

• Digital maturity and interoperability

• Medicines governance and dispensing responsibilities

Let’s look at a few of the key areas and what “evidencable compliance” + realistic action planning might look like.

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1. Safeguarding and Workforce Culture

Safeguarding policies and induction (2M, 2P, 6L, 6M, 6J)

The revised safeguarding questions go beyond “Do you have a policy?” and expect you to show that you have:

• Policies that cover:

  • Children and adults at risk

  • Domestic abuse

  • Mental Capacity

  • FGM and mandatory reporting

  • Information sharing and participation in statutory reviews

  • Freedom to speak up information

• Clear induction processes for all new healthcare staff and locums, including:

  • Practice safeguarding arrangements

  • Local LADO and PIPOT details

• Procedures and information-sharing agreements with multi-agency teams

• Up-to-date training records and competency assessments

If you’ve said “Yes” but the evidence is thin, your post-declaration action plan might be:

• Refresh and re-issue safeguarding policies to explicitly include:

  • Domestic Abuse, MCA, FGM, information sharing, statutory reviews, FTSU.

• Create or standardise a safeguarding induction checklist for:

  • Permanent staff

  • Locums and temporary staff

• Set up a simple safeguarding training matrix that can be pulled off the shelf if the ICB or CQC ask.

Workforce assurance and FTSU (2A, 2Q, 5AG, 5U)

You’re also being asked to demonstrate:

• A needs analysis and risk assessment for staffing levels (not just “we’re busy”).

• Up-to-date workforce data in the National Workforce Reporting Service (NWRS), including locums and temps.

• A named and trained Freedom to Speak Up (FTSU) Guardian, clearly referenced in your policy.

• A whistleblowing / speaking-up policy that reflects the 2022 national update.

If the spirit is there but the paperwork isn’t yet, consider:

• Writing a short workforce needs analysis that links:

  • List size

  • Demographics (age, LTCs, care homes, deprivation)

  • Current and planned staffing / skill mix

• Cross-checking HR records with NWRS and building NWRS updates into your joiners/leavers HR process.

• Publicising your FTSU Guardian internally:

  • Slides at practice meetings

  • Posters in non-public areas

  • A short “How to raise a concern” section on your intranet or shared drive.

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2. Access and Online Consultations (4ZA, 4ZB, 4Z, 4M, 4N)

The access questions – especially the new ones – are there to assure:

• Availability of online consultation tools throughout core hours (for non-urgent issues).

• Safe routes for urgent care, clearly directing patients to phone or in-person contact.

• Emergency access arrangements during core hours when the practice is not open.

Online consultation tool switched on (4ZA)

To answer “Yes” confidently, you should be able to show:

• Supplier configuration showing online consultations available across all core hours.

• An SOP for online consultations covering:

  • What types of requests are appropriate

  • Expected response times

  • Triage, allocation and safety-netting

• Basic usage data (even if just from the supplier dashboard) used for access planning.

If you’ve declared “Yes” but haven’t yet documented it, your post-declaration work might be:

• Capturing configuration screenshots.

• Writing a one-pager describing your online consultation model.

• Saving a quarterly report summarising:

  • Volumes

  • Response times

  • Any safety issues and changes made.

Urgent vs non-urgent messaging (4ZB, 4Z, 4M, 4N)

Regulators and commissioners want to see that urgent clinical need is never trapped in an inbox.

Practical, evidencable steps:

• Website homepage clearly stating:

  “If you need urgent medical advice today, please call us on [number] or attend the practice. Do not use online forms for urgent problems.”

• Posters / screens in the waiting room with consistent messages.

• Business continuity plans that explain:

  • What happens if phones fail

  • What happens if systems go down

  • How patients are told about any temporary change in access.

After the declaration, you might:

• Do a quick “walkthrough” as if you were a patient:

  • Website, phones, reception signage – is the urgent route absolutely clear?

• Document the outcomes and tweaks as a mini-access safety review.

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3. Communication, Patient Charters and Patient Safety (5AD, 5AE, 5AF)

“You and Your GP” / “You and Your General Practice” Patient Charter (5AD)

Publishing a link to the General Practice Patient Charter isn’t just a box to tick – it formally shows you accept and promote nationally-defined standards of:

• Access

• Respect

• Safety

• Information

A strong position looks like:

• A clearly visible link to the Charter on your website.

• PPG awareness and discussion of what it means locally.

• References to the Charter, where appropriate, in complaints handling and patient communications.

If you added the link in order to say “Yes”:

• Capture a screenshot for your governance evidence.

• Ask the PPG to help create a short “What this means at our surgery” explanation and publish it.

NHS England Primary Care Patient Safety Strategy & LFPSE (5AE, 5AF)

The patient safety questions indicate a shift from ad-hoc incident reporting to a structured learning system.

To stand behind a “Yes” you should ideally be able to:

• Show the team has been introduced to the Primary Care Patient Safety Strategy in:

  • A practice meeting

  • Training slides

  • Governance notes

• Demonstrate that the practice has:

  • An LFPSE administrator account

  • A process for deciding what gets reported

  • Records of incidents submitted and learning shared.

Post-declaration, a realistic evidence-building plan might include:

• Adding a “LFPSE reporting” section to your Significant Event Analysis template.

• Keeping a simple Excel or Word log of:

  • Date

  • Incident type/theme

  • Whether it was reported to LFPSE

  • Key learning and actions.

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4. Medicines Governance and Dispensing Responsibilities (5O, 5QA, 5QB)

Even if you are not a dispensing practice, the medicines questions reinforce:

• Safe handling and governance around controlled drugs.

• The expectation that practices do not prescribe in excess of what is reasonably necessary.

• For dispensing practices, evidence that patient choice is respected.

If you have declared compliance, ask:

• Do we have current SOPs covering:

  • CD storage, access, prescribing and destruction?

  • Adverse events, errors, near misses and learning?

• Can we show we do not routinely over-prescribe in cost or quantity?

Post-declaration, you might:

• Conduct a small prescribing audit to show:

  • Quantity and duration are appropriate

  • High-risk and high-cost drugs are handled in line with local guidance.

• Ensure your website and leaflets (for dispensing practices) clearly state that patients can choose to use a community pharmacy instead of practice dispensing.

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5. Digital Maturity and Interoperability (6UA, 6UB, 6V, 8UA, 8Z, 8ZA, 8ZH, 8ZJ, 8XBA, 8XCA)

The digital and interoperability questions are increasingly central:

• GP Connect (HTML & Structured) access to patient records (6UA, 6UB).

• Community pharmacy consultation summaries flowing into practice workflow (6V).

• Business continuity plans acknowledging digital failure and cyber-risk (8UA, 8RA).

• Shared Care Record access (8ZH).

• Patient communication via NHS App/SMS and sensible use of digital tools (8ZA, 8ZAB).

• Demand & capacity tools for appointments (8ZJ).

• Website usability and accurate NHS.uk profiles (8XBA, 8XCA).

If you’ve answered “Yes” to these:

• Capture the evidence now, even if it’s after the declaration:

  • GP system / supplier confirmation of GP Connect configuration.

  • Examples of pharmacy consultations received and processed in workflow.

  • The latest version of your Business Continuity Plan with digital incidents explicitly included.

  • Screenshots of your website and NHS.uk entries.

  • Evidence that you’ve used a website benchmarking tool or made specific improvements.

You can then go a step further and:

• Run small audits:

  • Are Shared Care Records actually being used in complex cases?

  • Are pharmacy messages reviewed in a timely way?

• Use demand & capacity reports to justify changes in session templates, recruitment or skill mix.

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“We Clicked Yes – Now What?”

Here’s the honest reality in most practices:

• You complete the eDEC as best you can.

• You give accurate answers, but you don’t have a perfect evidence pack behind every line.

• You mean to go back and build that evidence… then the day job happens.

The key is to recognise that:

Submitting the eDEC is not the end of the process – it’s the start of your evidence and improvement cycle.

If you’ve declared “Yes” where you are substantively compliant but your documentation is behind, your next steps are:

1. List the questions where evidence is thin.

2. Create a simple action plan for each:

   • What evidence will we create?

   • Who owns it?

   • When will it be done?

3. File the resulting policies, minutes, logs and screenshots in a clearly labelled “eDEC Evidence” folder (digital or physical), ready for:

   • ICB spot checks

   • CQC inspection

   • Internal assurance.

If you discover you’ve inadvertently overstated compliance, the safest and most professional approach is to:

• Correct the position with your ICB if needed, and

• Use that as a springboard to fix the underlying gap.

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Final Thoughts

The eDEC is not just a contractual formality.

It is:

• A live statement of your compliance with the GP contract and key regulations.

• A map of where your governance is strong, and where the evidence needs to catch up.

• A ready-made improvement agenda if you’re willing to use it that way.

On occasion, you will absolutely find yourself building or tightening evidence after you’ve made your declaration – documenting what you already do, or bringing the last 10–20% up to standard. That’s normal, and it’s sensible, as long as the underlying declaration was honest in the first place.

If you treat the eDEC as a one-off annual chore, it will always feel like a risk.

If you treat it as the backbone of your contractual assurance and regulatory readiness, it becomes one of the most powerful tools you have to protect your practice – and your patients.