PrescQIPP

Using CQC live data to improve medicines safety and patient outcomes across General Practice (2025)

Medicines Optimisation Team, NHS Cambridgeshire and Peterborough

Project summary

What We Did and Why

In early 2023, several Cambridgeshire and Peterborough (C&P) GP practices received “Inadequate” ratings from the Care Quality Commission (CQC), with most inspection concerns linked to medicines safety. Notably, even previously “Good”-rated practices believed their systems were robust. This disconnect raised concerns within the Integrated Care Board (ICB), as poor medicines safety processes pose significant risks, especially with high-risk drugs like methotrexate, DOACs, and lithium that can cause adverse effects or hospitalisation if not properly managed.
Beyond direct risks to patients, poor CQC ratings place a considerable burden on practice teams, impacting staff morale, recruitment, and the delivery of core GP services. Recognising this, the Medicines Optimisation Team (MOT) implemented a proactive and system-wide improvement model.

How We Did It

From April 2023, the MOT applied its improvement model to all 87 practices across the ICB. Using real-time CQC medicines safety data, practices were scored and ranked to identify outliers. High-risk practices were prioritised for clinical engagement, support plans, and process improvements. Interventions ranged from annual visits for top performers to weekly support where urgent safety concerns were identified.
Support included tailored face-to-face meetings, digital tools, clinical webinars, newsletters, and sharing best practices from high-performing sites. Where gaps in safety processes were identified, the MOT provided guidance that extended to broader clinical and operational areas, enhancing overall quality of care.

Outcomes

By April 2025, 97% of practices across C&P are in the top two national quartiles for CQC medicines safety indicators. None are in the lowest quartile. According to Eclipse data (June 2025), the ICB ranks in the top quartile for 7 out of 10 of the highest-risk indicators.
3 previously inadequate-rated practices have also seen significant improvement with 2 of the 3 now ranking in the first quartile and the third practice in the second quartile.

Impact on Patients and System

  • High-risk patients now receive appropriate monitoring and treatment, reducing preventable hospitalisations and complications.
  • More patients with CKD and diabetes are now managed in line with evidence-based pathways.
  • Over 200 patients with AF and stroke risk were assessed and prescribed anticoagulants, reducing stroke risk and treatment costs.
  • 115 respiratory patients are now better managed, reducing emergency admissions.
  • Older patients on NSAIDs/antiplatelets are more likely to receive gastroprotection, reducing GI bleed risk.

Return on Investment
While some safety improvements required increased prescribing (e.g., DOACs, addition of a gastro-protective treatment), these would be offset by significant system savings through reduced hospital admissions, better disease management, and lower emergency care demand.

The future
MOT use this process as a vehicle to raise other important prescribing issues like antimicrobial stewardship, making best use of SMRs.