Thank you to the hundreds of people who took the time to consider our first-round concepts and then completed the poll or sent us detailed comments.

In answer to the poll, 285 people told us:

  • Foundation Standard should include legislation, regulation, patient safety and equity (60%), compared with 40% support for only legislation and regulation;
  • The CORNERSTONE® Annual Programme should be retired (70%), compared with 30% support for keeping the Annual Programme;
  • CORNERSTONE® should become a set of modules to be accredited against (80%) compared with 20% support for remaining a one-size-fits-all standard and programme; and
  • If CORNERSTONE® becomes modular, 48% of respondents would like to see credit values assigned to the modules with practices having to attain a set number of credits to be accredited, compared with 52% preferring not to have credits attached to modules. 

We also received 120 written comments regarding the proposed concepts covering themes relating to time, cost, repetition/duplication of work, focussing on patient outcomes, including other standards in Aiming for Excellence, views on the annual programme, and support for practices. 

Consequently, the second design cycle was influenced by:

  • The concept of a mandatory set of core requirements (eg: Foundation) that advanced modules can be added to;
  • Quality improvement that focuses on improving patient outcomes is important to many of you; 
  • The annual programme is appreciated by people who like a structure that helps them stay up to date with their requirements, although other people find that structure onerous; and
  • There is a general expectation that a simplified quality programme means fewer criteria and a reduction in the assessment of items that don’t change, eg: disabled toilets in practices.

Share your thoughts

Read about the two concepts below, then complete this short survey. You can let us know of any other comments using the free-text box at the end of the survey.

Take the survey

About the review

To find out more about the CORNERSTONE® simplification project (including FAQs), click the button below.

Read more

The 2nd round concepts being proposed

1) Foundation Standard remains compulsory for all general practices, however, not all Foundation criteria need to be assessed every time.

One of the common criticisms about the current quality programme is that it reassesses items that don’t change, for example, items that are part of the practice’s infrastructure.

We are proposing that the unchanging items, eg: disabled toilets or disabled access to your practice is assessed once-only and then accepted at subsequent assessments without further checks, unless the item has changed or the legislation or regulation about that item has change.

What do you think? Is it enough to assess some Foundation criteria only once?

2) The CORNERSTONE® programme becomes a series of modules to be accredited against, instead of a one-size-fits-all programme.

This is the concept for a simplified quality framework for general practice.

It features:

  • Foundation is compulsory for all practices (no change from the current framework); and
  • CORNERSTONE® comprises Foundation, and a compulsory clinical quality improvement module, and another module of the practice’s choice.

Examples would be: 
Teaching practice = Foundation + clinical continuous quality improvement + teaching practice module
A ‘standard’ general practice = Foundation + clinical quality improvement + general practice module

If the optional modules are implemented, the CORNERSTONE® teaching practice module would replace the College’s current assessment to become a teaching practice. In addition, aspects of other independently certified or accredited standards could be recognised by the CORNERSTONE® programme and not need to be reassessed by CORNERSTONE® assessors. 

The practice may choose to complete just one optional module to meet the CORNERSTONE® programme requirements, or it may choose to do as many optional modules as it likes in addition to the one practice-chosen module.

What do you think? Does this proposed framework meet your expectation of a simplified system?

3) What do you think about these two concepts?

Complete the short survey below and let us know what you think about assessment visit frequency, training and more.

You can let us know of any other comments using the free-fill box at the end of the survey, or email

Tell us what you think

Mihi and acknowledgements
Thanks to our colleagues from practices and PHOs with expertise in developing and assessment of quality systems, and also Dr Lorraine Brooking of Te Akoranga a Māui for her invaluable guidance during our discussions about Māori health and health equity.