In May, we had 14 published Returning to Good reports to learn from. In July, that was 126. Today, it’s 248.
That’s not a small dataset any more. It’s a pattern. And this update is about what that pattern is telling general practice.
The headline still holds
Of the original 126 Returning to Good reports, 125 held or improved their rating. That’s the good news, and it’s real.
It comes with a qualifier we’ll keep repeating: that figure only covers assessments that stay inside the focused Returning to Good route. If CQC has real concerns, they can escalate to a full inspection instead — and those cases simply don’t appear in this number. Don’t read 125 out of 126 as “you’ll be fine.” Read it as a genuine, time-limited opportunity to get ready before your five days’ notice arrives.
One practice did lose its Good rating inside the focused programme itself, with no escalation. We told you about that one back in June.
It’s happened again
This week, we found a second practice with exactly the same fingerprint. Scored Inadequate on two of the ten quality statements. Moved straight to Requires Improvement. No escalation.
What this tells us: one Inadequate-level score on a quality statement still leaves you Good. Two, and you drop — with no warning shot in between. We’ve asked CQC why neither case was escalated, given their own guidance says they’ll consider it. We’ll let you know what they say.
A quieter first
Every below-Good score we’d seen until now sat in the governance and evidence layer — never in kindness, compassion or dignity. This week, that changed.
One practice was marked down there, driven by GP Patient Survey results that came in below average, with no action plan or local follow-up behind them. It’s the same pattern as everywhere else. It’s not the care that’s in question. It’s whether you can show you acted on what your patients told you.
Even “Good” isn’t all clean
Looking at the newest batch of reports, 40% of practices that held their rating still had at least one quality statement scored below Good along the way.
Of everything scored below Good across the board, roughly a third sits in staffing evidence — recruitment files, DBS checks, training records, supervision paperwork. Around a fifth each sits in safe environments and in governance oversight. Close to a fifth sits in infection prevention and control follow-through.
Nowhere near that share sits anywhere near the quality of care itself.
One to watch
From 30 July, CQC has started rolling out an “enhanced” version of the Returning to Good assessment for some practices. It’s the same fixed ten quality statements, plus medicines optimisation and delivering evidence-based care and treatment — with a GP Specialist Advisor or clinical pharmacist involved. Not every practice will get this tier yet. If your five-day notice call mentions “enhanced,” now you know what that means.
What this is really about
None of this is about the quality of care general practice is delivering. Across 248 reports, the story hasn’t changed: the gap is whether a practice can prove, on the day, what it already knows to be true.
That’s a governance problem, not a clinical one — and it’s a solvable one, if you start before the five-day call arrives rather than during it.
Today’s full webinar recording and slides are now available in our free community — including the Q&A, where we worked through the specific questions people are asking about their own practices.
Access the recording and slides — join the Harmony CQC free community → (https://1.hcqc.co.uk)