CQC’s new primary care framework: What GP practices should do now

The Care Quality Commission (CQC) is retiring the single assessment framework it introduced in January 2024, and replacing it with four sector-specific frameworks, one of which covers primary care and community services. The consultation on these drafts closed 12 June, and CQC has already begun to pilot to the new general practice model, running from June to October 2026.

While practices are still assessed under the current framework while this pilot runs, there is now enough detail to start planning for the changes to come.

What is changing for GP practices?

The draft primary care and community services framework keeps the five key questions but rebuilds everything underneath. The 34 quality statements are replaced by structured key lines of enquiry, with each one carrying new rating characteristics which describe what outstanding, good, requires improvement and inadequate look like for the sector. Additionally, scoring is removed, and “I statements” taken from the Making It Real framework, sit alongside the technical detail to keep patient experience central to the judgement. The key lines of enquiry are organised as follows:

Safe: Safety culture, managing risks during care and treatment, safe systems and transitions between services, safeguarding, safe environments and infection control, safe staffing, and safe delivery of treatments and medicines.
Effective: Assessing needs, delivering evidence-based care and outcomes, supporting people to live healthier lives, and consent to care and treatment.
Caring: Kindness, compassion and dignity, person-centred care, and independence, choice and control.
Responsive: Care provision, integration and continuity, listening and responding to feedback, timely and equitable access, and equity in experience.
Well-led: Strategic direction, workforce equity and culture, capable and compassionate leaders, governance, management of risk and performance, partnerships and communities, and improvement, innovation and learning.

There are also some specific points in the primary care draft, that go beyond a rename of existing quality statements:

Technology and AI in clinical pathways appear explicitly for the first time, both as a safety consideration (systems used to deliver care, including AI, must be suitable, secure and properly used) and as a marker of outstanding practice (identifying and implementing AI in clinical care pathways).
Population health data is now built into the effective and well-led domains. CQC wants to see practices using population health data to target prevention work and reduce inequalities.
Workforce equity and culture is a standalone key line of enquiry in its own right, covering the gender pay gap, Freedom to Speak Up arrangements, and equitable treatment of staff. This sits closer to HR and payroll governance than to clinical practice, and is worth a conversation with whoever manages your people data.
Digital exclusion and remote or online consultations are assessed explicitly under both effective and responsive domains, reflecting how much primary care activity now happens outside a face-to-face appointment.

Key dates

24 March 2026: The four draft frameworks were published for consultation, including the primary care and community services framework.
12 June 2026: The consultation closed.
June to October 2026: CQC is running a dedicated pilot of the general practice framework. Practices in the pilot remain under the current single assessment framework for live inspections and ratings while the pilot tests the new model.
November 2026: CQC’s evaluation of the pilot programme is due. The final sector-specific frameworks are expected to reflect what this evaluation finds.
Late 2026: Implementation is targeted to begin, completing by the end of the year. With pilot evaluation not due until November, this timeline is tight and may slip. The current framework stays in force until the new one goes live, and CQC has told providers to keep working to existing published guidance in the meantime.

These dates are correct as of 10 September but remain provisional. We will update this blog when more specific dates are confirmed.

What practices should be doing now

The draft outlined in this article is not final, so it is too early to rebuild your compliance systems around it. Nevertheless, CQC’s expected evidence base aligns closely with good financial and governance reporting, which practices can strengthen now:

Don’t restructure your governance systems around the draft content. Wait for CQC to confirm the final version before committing resource to it.
Do strengthen the evidence trail underneath your current governance. The new rating characteristics reward practices that can show a learning culture and demonstrable outcomes. Management accounts, KPI reporting, complaints logs and quality improvement records all carry across from financial governance into a CQC assessment.
If your practice is in the general practice pilot running June to October 2026, get your evidence pack in order now rather than waiting for a pilot visit to expose the gaps.
Check your workforce reporting. Gender pay gap data and Freedom to Speak Up arrangements are now an explicit line of enquiry, not background context. If your practice doesn’t already produce this reporting in a structured way, this is the moment to start.
Factor CQC ratings into any partnership, merger or sale timeline you are already planning. Ratings affect commissioning access, indemnity and insurance pricing, and how a practice is perceived at the point of a partnership change or exit. A rating movement during a framework transition is a variable worth considering.

Where Price Bailey’s healthcare team fits in

This is a regulatory change, and the clinical and inspection detail sits with CQC and with your own governance leads. Where the Price Bailey healthcare team adds value is on the financial side of that same evidence base: benchmarking practice performance against sector data, building governance and management reporting, including workforce and pay gap reporting that stands up equally well to a CQC assessment and to a bank, buyer or funding body.

If you want a second set of eyes on your practice’s financial and governance position ahead of the new framework, get in touch with the Price Bailey healthcare team using the form below.

We always recommend that you seek advice from a suitably qualified adviser before taking any action. The information on this page is intended as a general guide only. While we work to keep our content accurate and up to date, we cannot guarantee that it reflects the position at the time you are reading it. No responsibility for loss occasioned by any person acting or refraining from action as a result of this material can be accepted by the authors or the firm. For more information on our editorial process, click here.

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