Personal reflections on the inspections of the Defence Medical Services by the Healthcare Commission and Care Quality Commission

The Defence Medical Services (DMS) have been inspected by the Healthcare Commission and by the Care Quality Commission. Both inspections reported a mixed picture: high quality in some areas, particularly those concerned with operational casualties, but room for improvement in other areas, particularly the infrastructure of home-base primary care. The DMS valued the external validation of their own systems of quality assurance, and the findings of the inspectors have supported progress in areas where resource constraints have been difficult to overcome. Other findings have encouraged attention to areas of practice that needed improvement. The benefit of these inspections cannot be realised unless the organisation is prepared to accept adverse observations not as criticism but as opportunities for improvement. The inspections also benefitted the inspectors, providing a different and interesting clinical environment, and some benchmarking for future inspections of civilian general practice.