Safe Systems, Pathways and Transitions: What Good CQC Compliance Looks Like in Practice

To complement the second of The Medicines Management Team’s ‘Let’s Make Lemonade’ CQC ‘Safe’ webinars, this blog explores the CQC quality statement of ‘ Safe systems, Pathways and Transitions’.

As always, let’s start by understanding what the CQC means by safe systems, pathways and transitions:

We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services:

• Continuity of care is a priority throughout people’s care journey. This happens through a collaborative, joined-up approach to safety that involves them along with staff and other partners in their care. This includes referrals, admissions and discharge, and where people are moving between services.​

• Care and support is planned and organised with people, together with partners and communities in ways that ensure continuity.​

• The views of people who use services, partners and staff are listened to and taken into account.​

Essentially therefore, compliance with this quality statement is based on whether a practice has reliable, repeatable ways of keeping patients safe as they move through your care and across organisational boundaries (e.g., hospital discharge, out-of-hours handovers, referrals, and community services). 

As readers will be familiar with by now, when it comes to the CQC, a sensible policy or protocol is not enough; inspectors will be looking for evidence that these are used, monitored, continuously improved, and doing what they are actually set out to do i.e. keep services and transitions safe. In other words, a rating of ‘good’ is likely if:

• The practice has clear pathways for common and high-risk scenarios

• Staff know what to do, where to find the SOPs, and who to escalate issues to

• The practice can demonstrate evidence of safe handovers (internal and external)

• The practice has evidence that it learns from issues (complaints, significant events, near misses, safety alerts)

• The practice can evidence audits/spot checks and changes made as a result

Here are some practical applications of this quality statement that most practices will already be doing, that demonstrate ‘good’ compliance in this quality statement:

• Following a standard process for receiving and acting on inpatient discharge summaries

• Tracking and safety netting all 2ww referrals 

• Following a standard process for receiving and acting on pathology results 

• Following a standard process for receiving and action on out of hours contacts

• Having robust internal cover arrangements in place for tasks/documents/pathology

• Use of the NHS app to keep patients informed of their care

• Use of interoperable IT systems (e.g. to communicate to community nursing teams)

• Summarising and scanning protocols for paper notes

• Clear application of triage protocols

• Clear policies for shared care arrangements with system pop-ups and alerts

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 series on our Youtube channel.