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GPs face year of ‘severe stress’ over CQC red tape

By Gareth Iacobucci

Exclusive: GPs face ‘severe stress' and up to 90 hours of preparatory work after it emerged that practices would be expected to submit evidence for the Care Quality Commission's compulsory registration scheme from October.

Practices will need to meet 21 sets of regulatory requirements, laid out in a 300-page guidance document, and those with multiple branch surgeries face having to fill in forms and pay registration fees separately for each location.

News of the looming deadline came as the British Dental Association, whose members were registered last week, a year ahead of GPs, warned the process had been ‘shambolic' and ‘lurched from one crisis to another'. It said it had ‘serious concerns over what our medical colleagues could be subjected to'.

Practices will start submitting evidence online in October this year, with a December deadline to demonstrate compliance in areas as diverse as equipment safety, record keeping and management structure, in order to be registered with the CQC from 1 April, 2012.

GPs will be required to adhere to CQC outcome standards already applied in other areas of health and social care, including respecting and involving people who use services, co-operating with other providers, safeguarding people who use services from abuse, medicines management and safety of premises (see box).

The CQC is still to consult on the thorny issue of GP registration fees – reduced from £1,500 to £800 per surgery for dentists following widespread revolt – but told Pulse it was likely to continue the policy it has adopted with hospitals and care homes of asking providers to register per location.

A spokesperson said: ‘We register care homes as individual instances of care. Even if a provider has two or three, it's the locations that are registered. I would be very surprised if we broke from the model we've done for everyone else.'

But the spokesperson insisted the regulator would be flexible when setting fees, adding: ‘We will listen to the industry and we are flexible.'

The spokesperson said GPs would have to adhere to ‘a common set of standards' already applied to hospitals and dental practices, also encompassing areas such as complaints handling, infection control and managerial issues such as ensuring all staff have had criminal record checks.

But Susie Sanderson, chair of the BDA's executive board, said: ‘The registration of dental providers has been shambolic. Even now, with the deadline having passed, large numbers still haven't had applications processed properly. We've encountered problems with admin, problems getting CRB checks verified and inconsistency in advice from the CQC.

‘The process has lurched from one crisis to another, causing the profession severe stress. Given the problems encountered with a relatively small profession such as dentistry, I have serious concerns about what our medical colleagues could be subjected to.'

Dr Philip Cox, a GP in Buxton in Derbyshire – where the CQC has begun piloting registration in GP practices – said his practice would probably have to close one of its three branch surgeries if they had to be registered separately: ‘It could ruin our branch surgeries. It's a hammer to crack a nut.'

Graham Knight, senior partner at consultancy firm Res Consortium, which has worked with dental practices to prepare them for last week's registration deadline, claimed some had given up half a day a week for six months to ensure they met registration standards.

He said: ‘Typically I've been working with practice leads over a six-month period. I would set aside a morning a week to review progress, but there may be weeks where you have to allocate a whole day every two weeks.'

Mr Knight said larger practices had generally found it easier to cope with registration than small ones: ‘Smaller practices need to have a very solid plan. Take a look at the outcome families and see what's missing. If you start now, you've got a better chance.'

Dr Philip Cox Outcome indicators

. Respecting and involving patients
. Consent to care and treatment
. Registration fees – (to be consulted on later this year)
. Care and welfare of patients
. Meeting nutritional needs
. Co-operating with other providers
. Safeguarding patients from abuse
. Cleanliness and infection control
. Management of medicines
. Safety and suitability of premises
. Safety, availability and suitability of equipment
. Requirements relating to workers
. Staffing
. Supporting workers
. Statement of purpose
. Assessing and monitoring quality of service provision
. Complaints
. Notification of death of a person who uses services
. Notification of death or unauthorised absence of person detained or liable to be detained under Mental Health Act 1983
. Notification of other incidents
. Records

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