A CQC rating of Requires Improvement means the service needs to improve in the areas identified by the assessment. Start with the actual report, the evidence behind its findings and any regulatory action. A rating should not be reduced to a single presumed medicines breach or a missing-documentation problem.
Start with the findings
Identify the areas assessed, the quality concerns and any regulation cited. Distinguish a gap in care from a gap in the evidence available, then establish what needs to change. Address immediate patient risks first.
Read the report alongside CQC’s current assessment and ratings guidance. Other evidence, including patient experience and leadership, may also be relevant; medicines work is one part of a practice’s overall service.
Medicines-related concerns
Review the specific findings about prescribing, monitoring, medication reviews, safety alerts or record keeping. Clinical searches can help identify records for further assessment, but a search result does not alone establish unsafe care or a regulatory breach.
Our guide to CQC clinical searches explains access and review of the output. The medicines governance guide covers common areas to examine without treating them as a diagnosis of every practice’s problem.
Build an action plan
For each finding, record the action, responsible person, timescale and evidence of completion. Include any required patient review, communication or monitoring, rather than only updating a policy.
Separate immediate corrective work from changes to the ongoing process. For example, reviewing overdue monitoring and improving the recall system are related tasks, but completing one does not prove the other is reliable.
Sequence work by risk
Do not wait for a generic 30-, 60- or 90-day milestone when clinical urgency requires earlier action. Agree realistic timescales that reflect patient risk, the report and any formal requirement. Premises, staffing, safeguarding and other concerns may need action alongside medicines work.
Review progress regularly. Check a sample of completed actions, confirm that outstanding work has a clear route forward and use repeat audit where appropriate to assess whether improvement is sustained.
Record care accurately
Document assessments and decisions when they are made. Correct inaccurate records transparently and preserve the audit trail. Changing codes alone cannot resolve care that has not happened, and a missing entry should prompt investigation rather than an assumption about what occurred.
Where external clinical support fits
Virtual Pharmacist can support the agreed medicines-related part of an action plan through remote clinical reviews, monitoring, reconciliation, prescribing within competence and documentation. Scope, escalation and reporting are agreed with the practice.
Frequently asked questions
Is every Requires Improvement rating a medicines breach?
No. Read the actual findings, areas assessed and any regulations cited. Medicines can be one concern among wider issues affecting the service.
Can coding changes alone resolve a finding?
No. Establish whether care, documentation or both need attention. Complete appropriate clinical actions and correct records transparently.
Should every practice follow the same 90-day plan?
No. Timescales must reflect clinical urgency, the findings and any formal requirements. Immediate risks need prompt action.
Can a pharmacy provider guarantee a Good rating?
No. A provider can support agreed medicines-related actions and evidence. CQC assesses the wider service and determines the rating.
External support does not guarantee a rating or replace the practice’s wider improvement work. Read about our CQC preparation service or contact us to discuss the clinical work identified.
Primary references
CQC: how ratings are reached; CQC guidance on Regulation 12; CQC guidance on clinical searches. Check the current CQC assessment guidance when planning a response.
