top of page

CQC Safe Webinar Series: Learning Culture

Updated: Feb 10


Navigating the CQC Assessment Framework: Building a ‘Safe’ Learning Culture

The first of TMMT’s ‘Let’s Make Lemonade CQC ‘Safe’ webinar series has kicked off this week, this blog will summarise the key points from the ‘Safe’ Key Question of the CQC’s Assessment Framework, and the first Quality Statement that sits beneath it: Learning Culture. 


The landscape of primary care in the UK is evolving rapidly, placing unprecedented pressure on General Practices to maintain high standards of safety while managing increasing workloads. Within the CQC Assessment Framework, the "Safe" key question often feels daunting, yet it remains a fundamental pillar of quality care. Achieving a high rating requires more than just clinical excellence; it demands a comprehensive "Learning Culture" where safety is woven into every organizational thread. 


Understanding the "Safe" Expectation in Primary Care

From a CQC compliance perspective, "Safe" has a very specific definition that extends beyond the consulting room. It signifies an environment where leaders promote a culture of collaboration and openness, ensuring people are protected from avoidable harm, neglect, and discrimination. 


The CQC’s definition of ‘Safe’ is:


Safety is a priority for everyone and leaders embed a culture of openness and collaboration. People are always safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty is protected where this is in their best interests and in line with legislation.


This is then broken down into the following expectations:

●    Where people raise concerns about safety and ideas to improve, the primary response is to learn and improve continuously.

●    There is a strong awareness of the areas with the greatest safety risks.

●    Solutions to risks are developed collaboratively.

●    Services are planned and organised with people and communities in a way that improves their safety across their care journeys.

●    People are supported to make choices that balance risks of harm with positive choices about their lives.

●    Leaders ensure there are enough skilled people to deliver safe care that promotes choice, control and individual wellbeing. 


Colleagues working in primary care tend to focus on clinical and medicines safety, which of course forms part of what the CQC is looking for, but as the above demonstrates, the CQC is also looking for staff to be safe, and for the organisation itself to be safe demonstrating it is being robustly run.



SIGN UP FOR THE UPCOMING WEBINAR



Practical Scenarios of Safety in The Workplace

Safety is therefore best considered to be a golden thread of absolutely everything the provider does in terms of its service delivery and its internal business functions. Providers in primary care can very quickly think of examples of how clinical safety is managed and maintained, but it comes less naturally to us to think of examples outside of the consulting room.


For example, consider a GP partnership meeting wherein annual leave over the summer holidays is being discussed. This would not typically be a subject matter where one would naturally think ‘this is an example of us keeping things safe for our patients’, but actually it very much is. Minimum staffing levels are being discussed in order to ensure patient and staff safety isn’t compromised. We could all get a bit better at making a mental note of those sorts of discussions so that we can use them as evidence for ‘safe’ practice. 


Equally, staff feedback that shows that employees are feeling valued, respected and not discriminated against is firm evidence for the CQC that you are ‘safe’. 

If you are looking for some guidance on where to start with embedding safety throughout clinical and organisational processes, I would recommend starting with these free resources from Gary Hughes, a member of the webinar panel, which include the seven pillars of clinical and organisational governance. 


Developing a ‘Safe’ Learning Culture

Diving deeper into the ‘Safe’ key question brings us to the first Quality Statement of ‘Learning Culture’. This is described as:


●      Safety is a top priority that involves everyone, including staff as well as people using the service. 

●      There is a culture of safety and learning. This is based on openness, transparency and learning from events that have either put people and staff at risk of harm, or that have caused them harm. 

●      People and staff are encouraged and supported to raise concerns, they feel confident that they will be treated with compassion and understanding, and won’t be blamed, or treated negatively if they do so. 


It’s clear when reading the definition, that ‘culture’ isn’t something that can be demonstrated by a policy. It may be demonstrated through processes (for example if there is a constant trickle of SEAS, complaints and compliments being dealt with which implies that staff feel comfortable in reporting such things), but it will certainly be obvious through speaking to staff, which is what the CQC will do. 


Staff will be asked if they feel free to speak. If the culture of the organisation is one that promotes psychological safety, then staff will feel ‘free to speak’.


Psychological Safety: The Core of a Safe Culture

A true learning culture cannot exist without psychological safety: the belief that one will not be punished or humiliated for speaking up with ideas, questions, or mistakes. The CQC specifically looks for evidence that staff feel "free to speak". 


To assess the levels of psychological safety in your organization, consider these key questions: 


● If you make a mistake on your team, is it held against you?

● Are you able to bring up problems and tough issues?

● Do people on the team sometimes reject others for being different?

● Is it safe to take a risk?

● Is it difficult to ask other team members for help?

● Do people on the team deliberately act to undermine your efforts?

● Are your unique skills and talents valued and utilized? 


When practices partner with TMMT, they gain access to a team that understands these nuances, helping to foster an environment where staff feel confident and supported rather than blamed. 


Realistic Impact on Workflow and Safety

Integrating structured pharmacy support has a tangible impact on the daily operations of a GP practice. For instance, by recording not just harm, but also "near misses" and examples of good care on the Learn from Patient Safety Events (LFPSE) service, practices can demonstrate a proactive approach to safety. 


In terms of processes, a provider will be expected to show that an event has been reported, learning has occurred, the learning has been shared with everyone, and that the learning has become embedded. If we take a significant event analysis for example, this would require: 


●      The event being raised in a timely way and being treated as a learning opportunity

●      An MDT wide discussion about the event and how it could be avoided in future

●      Dissemination of the learning points to all staff (for example my email)

●      Staff confirming that they aware of what has been disseminated (usually checked by CQC inspectors asking staff to remember some recent SEAs and the learning points)

●      A plan for creating actionable the learning points

●      A check that these actions have been carried out and the issue has not reoccurred 


Furthermore, using OPEL (Operational Pressures Escalation Levels) reporting to flag when workload pressures impact patient safety provides firm evidence to the CQC that the practice is being robustly and safely run. These administrative and clinical safeguards ensure that the "Safe" requirement is met across all care journeys.

 

How TMMT Enhances Your Learning Culture

Working with The Medicines Management Team (TMMT) helps practices get more value from their pharmacists and pharmacy technicians by providing a pre-built structure for safety and governance. TMMT supports practices both operationally and clinically by unburdening clinical work and passing it to highly trained professionals. 


A "Learning Culture" is based on transparency and learning from events that put people at risk. TMMT pharmacists are trained to facilitate this by: 

  • Closing the Loop: Ensuring that when an event is reported, learning is shared and, crucially, embedded into future practice.

  • Facilitating MDT Discussions: Engaging in multi-disciplinary team talks to analyse significant events and how to avoid them in the future.

  • Supporting LFPSE Compliance: Assisting practices in using the LFPSE service, which is now a contractual requirement. 


Practical Suggestions for evidencing ‘Safe’

I will end with two practical suggestions that your practice could adopt tomorrow to help demonstrate in meeting the requirements of ‘Safe’. 


It is now a contractual requirement for practices to register with the Learn From Patient Safety Events (LFPSE) service and use it. However instead of simply using it, practices can provide useful evidence for ‘Safe’ by using it to record all events where harm occurred or could have occurred, such as: 

● Poor outcomes where contribution of an incident is unclear

●    Identify future risks

●    Examples of good care that others can learn from 


Then, in order to ‘close the loop’ and satisfy the regulator, you can schedule a regular ‘safety’ meeting to review entries on this service (and other events), check for learning and embedding of process changes.


A lot of ICB areas now have ‘OPEL’ or equivalent reporting for primary care providers to report when workload and operational pressures are impacting patient safety. Evidence of doing this reporting and therefore escalating the issue, alongside evidence of reducing non-urgent work to protect safety, should all be produced as evidence of CQC ‘Safe’.


SIGN UP FOR THE UPCOMING WEBINAR



Conclusion

In summary, while the "Safe" key question is complex, it is achievable through a committed learning culture and the right operational support. By prioritizing psychological safety and robust reporting, practices can move beyond simple compliance to a state of continuous improvement and excellence.

I hope this article has drawn attention to what existing activities can be used to successfully demonstrate the ‘safe’ requirement to CQC.


Watch the entire webinar below.



 
 
 

Comments


HAVE SOMETHING ON
YOUR MIND?

Submit an enquiry, and a member of our team will respond within 24 hours.

The Medicines Management Team Logo

Email Address: 

info@medicinesteam.co.uk


Telephone: 01274 317497

Head Office
14 Chapel Street
Bradford
Little Germany
BD1 5DL

  • LinkedIn
CPD Member Certification Logo
CE Plus Logo PNG.png

Training Suite One

Bradford Chamber Business Park
New Lane
Bradford
BD4 8BX

Hub26 Training Suite Two
Lawrence House
Riverside Drive
Cleckheaton
BD19 4DH

Providing NHS Services

NHS Logo

© 2026 The Medicines Management Team All Rights Reserved.

bottom of page