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DH and CQC discuss closer inspection of practices’ antibiotics prescribing

GP practices are set to face closer scrutiny of their antibiotics prescribing in future CQC inspections under plans being hatched by the Government.

The Department of Health confirmed to Pulse it was working with the CQC to find ‘more ways of improving antibiotic usage’ in future CQC inspections of GP practices.

But GP leaders said GPs were already scrutinised closely on prescribing of antibiotics in particular and as a result were ‘probably the best antibiotic prescribers in the world’.

The move came to light after the chief medical officer Dame Professor Sally Davies announced she was working with the CQC to ramp up checks on infection control and antimicrobial stewardship in the NHS.

Dame Sally said ‘we are working closely with the Care Quality Commission to explore how infection prevention and control and antimicrobial stewardship aspects can be built into the key lines of enquiry used in their routine inspections’.

The CQC already uses two metrics to rate practices on antibiotic prescribing – based on how much they prescribe antibiotics overall, allowing for the age and gender balance of the individual practice, as well as the proportion of these are broad spectrum antibiotics.

However, the Department of Health confirmed to Pulse that it was working with the CQC to find further ways to monitor GPs’ antibiotic prescribing.

A DH spokesperson said: ‘Tackling antibiotic resistance is key to protecting our precious medicines, and this work starts with good practice in hospitals and GP surgeries.

‘The CQC currently looks at all GP practices for their cleanliness and hygiene as well as the type of antibiotics being prescribed. We will continue to work with the CQC in the coming months to look at even more ways of improving antibiotic usage.’

It comes as a study revealed that GPs at practices that prescribe fewer antibiotics overall tend to receive worse patient satisfaction scores than those at higher prescribing practices in the GP Patient Survey.

Dr Richard Vautrey, deputy chair of the GPC, said the DH and other health bodies have been reviewing and monitoring GPs’ prescribing of antibiotics ‘for decades’ and that the CQC already had access to a ‘significant amount of data relating to antibiotic prescribing’.

Dr Vautrey added that it was something GPs ‘take very seriously’ and that ‘as a result we probably have the best antibiotic prescribers in the world’.

The CQC declined to comment on how antibiotic prescribing might be scrutinised more closely in future inspections but a spokesperson said the organisation was ‘about to go out to consultation’ on a new strategy and that ‘we recognise that infection control and antibiotic prescribing are important issues and we already look at them within our safe and effective domains’.

Readers' comments (22)

  • Be better sniffing each other's butts.

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  • A watched kettle never boils.

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  • I wonder if someone independent will critically look at all NICE guidelines and advise the profession as to whether they are all flawed as virtually all trials with -ve results arent published (50% of all trials ),or stopped early ,the bias is even worse if they are drug company funded , and a lot of the trial data on which NICE decisions are based are years old -and so were never subject to the pressure that trials are all under now -ie to be published whatever the results

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  • given the "quality" of the CQC inspectors & their clear in depth understanding of all things relating to primary care & general practice I'm sure we will get a completely rational & informed & sensible approach - similar to what they do now! After all now we use disposable paper curtains none of our patients have contracted any life threatening infection in the surgery for a couple of years! - an obvious correlation & clear link to the power of the CQC & our beloved ex leader - o wise one...........

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  • Why look at a practice rather than indivdual GP's. I wouldn't want to be judged on the irresponsible prescribing habits of my old senior partner. And if Dame Sally wants to actually do something for public health, how about she speaks up about the disgraceful cut in funding for weight management and smoking cessation? She has her knighthood already doesn't she? And what does any of this matter when general practice is on the brink of collapse so there probably won't be anything left to inspect by the time they get their act together.

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  • To have any value, as opposed to trying selectively to intimidate and threaten GPs until they are so frightened to prescribe antibiotics that untreated serious infections escalate, "Dame Sally" (?) would also have to inspect hospital prescribing, veterinary prescribing and the tipping point for reduction in prescribing and rise in serious infections. Even then, a blanket level of prescribing won't identify whether each script was clinically indicated - it who you treat not just how many.

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  • Until the widespread use of antibiotics used in farming is tackled we don't stand a chance.
    Why don't they look at this? Oh, I forgot, there's loadsa money involved.

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  • Oh f*ck off. In Europe they are bought over the counter, and we're all leaving so that will soon be the only option here. Good luck.

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  • CQC inspect places where care is delivered . I deliver care in the patients home when on a visit. All homes should be CQC inspected before I am cleared to deliver care there . No CQC inspection , then sorry -it's not a suitable place to deliver care. So no home visits .

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  • 'Why look at a practice rather than indivdual GP's. I wouldn't want to be judged on the irresponsible prescribing habits of my old senior partner. '

    Things that could explain a difference in prescribing habits: variation in demographics; older partner seeing well patients for weekly bloods and younger doctor seeing more acute infections; other doctor seeing more psychiatric type patients and heartsinks; different duty rota schedule at different times of the week; variation in number of patients seen and number of sessions; proximity to walk in centres or minor illness units; number of children on list; specialist MSK injection clinics and minor surgery clinics etc.

    And that's just between doctors in the same practice. How can any meaningful comparison be made?

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