3.8 consultations per year!
Its not scientific I know but looking at my mornings list the patients had, on average, consulted 7.5 times in the last calender year which is much more in line with the Nuffield Trust report highlighted by Pulse last year.
That's until NHSE decides to list cleanse and cross them all off when they can't be contacted. They will then publicise that GP's have thousands of ghost patients with the clear implication that we are all fraudulent.
As I have posted on the other GMC thread on emotional resiliance - the GMC's own report into suicides whilst under investigation documents that although their policy is to produce a Significant Enquiry Report for each and every suicide and for that to be reviewed by " GMC Directors", they could not produce evidence of any such process in 29% of cases.
If that's not institutional negligence I'm not sure what is.
Can there be any residual doubt that CQC is not fit for purpose?
CQC chose to make "intelligent monitoring" public. It follows that someone should publicly be seen to take responsibility for its failure and subsequent reputational damage to at least 519 practices.
Will anyone have the decency to do so?
Correction - Autumn 2017
If this is going to be contractual from 2016/17 it follows that we should start with that tax year - results of which will not be available from our accountants till the Autumn of 2018.
By then income will have fallen so much that the results will embarrass Government not us.
Publishing income on an hourly rate is an excellent suggestion.
Dr Field has not taken the opportunity to respond to my challenge on his reference to "the other matter". That being the case I have heeded the advice of some of the contributors to the debate and made a formal complaint to the CQC.
I earlier clarified that the errors were in the draft and were spotted and corrected by us. I don't think that this detracts from my point, that it is incredible that an inspection can end with an incorrect recording of the number of partners in a Practice and furthermore record that staff who left years before are still on the books.
If a CQC inspection is to have any value I think the bare minimum requirement should be that the CQC understands who does and does not provide clinical services.
Prof Field has made no mention of "the other matter" - its a reference that has hugely angered me and a number of other contributors. I cannot believe that this has slipped his mind.
I think that we all deserve an explanation of his motives when he made this comment, a comment that he made from his CQC viewpoint, that information is not recorded in any public domain.
I am grateful for the messages of support received here and elsewhere.
What I would love to ask is from where CQC gets the mandate to decide to act against Practices in this way?
I don’t ask this out of idle curiosity.
I am a member of my CCG’s Governing Body with a remit of Primary Care Quality. A fundamental part of my role is to support Practices that are finding life tough. It has always been our assumption that any more draconian monitoring of these Practices would be by NHS England who hold Practices Contracts. NHSE locally at least shares the same view.
Is it really the case that struggling Practices are going to be clobbered by both NHSE and CQC and if so to what end? Is one monitor not enough and if so should it not be NHSE who at least have a clear mandate, local insight and a level of accountability that CQC, as a bit of a Quango, does not appear to have?
Steve Field - WE CHECKED the draft and pointed out the discrepancy.
As for "the other matter", the records that you have so hastily reviewed should record that "the other matter" arose because we were given erroneous advice by CQC. The inspection team promised to clarify for us - did not do so and when we chased it up denied having promised to do so - the promise made to me was witnessed by our Practice Manager. I am sure that our email trail and documentation is still held on file.
For those curious to know what the mysterious "other matter" might be it relates to CQC registration for a small minor surgery service that had nothing to do with the Practice CQC inspection.
Yes Dr Field it is in hand (delayed by CRB back-log) BUT I think it very very poor form indeed that you feel it appropriate to bring "the other matter" up in a public discussion. Can I ask what it was you hoped to achieve by bringing it up in this way? You have offered a private email dialogue – would it not be more appropriate to use that avenue. You have worked out who I am and where I work, contacting me behind the scenes would be an easy matter.
That you have so hastily sought to identify me, review my Practice inspection and seek to bring to my attention that you are aware that “the other matter” is known to you might be regarded as a warning that someones watching me.
I can’t help but feel that this is not CQC’s finest moment.
Steve Field - it was at the draft level that we spotted it. Don't really think that this is pertinent.
If an inspection might, as we are now told, lead to Practices being labelled as "failing" then I think that we are entitled to know that the inspection is sufficiently rigorous to be able to achieve an accurate head count and not document ex-employees as still being on the books.
When the CQC inspected us we received a (glowing) report which falsely identified us as a two partner Practice despite the inspection team meeting all three partners and identifying by name a Practice Nurse supposedly employed by us despite her leaving the Practice two years earlier.
My experience suggests that CQC is incompetent - can I put them into "special measures?"
Siraj - I agree with you on bickering.
This is an attack on all. The DOH has decided that PMS budgets are ripe for (cost) cutting.
Watch out for a further exodus of partners if this happens and more work for those left behind.
1) DNA's have by definition been given an appointment, presumably at a time that they were happy with, so where's the problem with access?
2)DNA's are also by definition too feckless or inconsiderate to inform the practice that they are not coming and so allow the slot to be made available to others. Why would we want to make their lives more "convenient?"
3)Anyone with any significant experience of clinical medicine, I am assuming that Dr Poulter is not one of them, will understand that DNA's are the KY Jelly that allows the rest of NHS Healthcare to progress smoothly. Lets face it, they are a godsend. We struggle to cope with 340 million attendees - an extra 6 million, all in the name of "convenience", would be unwelcome.
This is the second profoundly stupid pronouncement from our political masters this week. God alone knows what will be next.
I fully support the notion of workforce planning. It .may shine a light on a problem that the DOH seems to deny exists
Two flies in the Sudocrem though
1)Without action to deal with the underlying issues it will achieve nothing.
2)I am told that it is hugely bureaucratic to complete. PM's are just as overwhelmed as GP's these days and the extra workload is not welcome.
I don't think that anyone outside Primary Care actually understands that there is a clear and present danger of a manpower crisis. Perhaps what is required is for the GPC or other agency to maintain and publish online a log of GP's intended date of retirement. I know that NHSE is trying to establish such a register though I doubt that it would publish the findings.
I am happy to start the ball rolling - April 2018 when I will be 55 - if I can hold out that long.
"The CQC’s report – which was based on interviews with 180 families and 23 inspections"
So very scientific given there are, I am told, 8230 Practices in England and around 15 million families.
Aside from that is this not a commissioning issue?
Does Field and CQC have a clue? No answers on postcards please, I think we all know the answer to that one
Dr G you should worry less about GP's wanting to be anonymous and more about us wanting to be heard.
More evidence that the CQC is not fit for purpose.