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New regulator gets tough powers over GPs

GPs face a tough new layer of regulatory bureaucracy with the launch of hard-hitting plans to scrutinise and report on practice performance.

Details emerged this week of the sweeping powers to be handed to the new Care Quality Commission, including practice inspections and stringent prescribing monitoring.

The frequency of inspections – which are set to be conducted by PCTs – will be stepped up for poorly performing practices, with tough new sanctions for those that do not improve.

GPs judged to be failing face statutory warnings and cautions, cancellation of their registration and, in extreme cases, imprisonment.

The Department of Health told Pulse the regulator would initially focus on GPs carrying out ‘more complex interventions', with PMS practices and GPSIs among the first wave to face inspections.

The new regulator will subsume the Healthcare Commission, Commission for Social Care Inspection and the Mental Health Act Commission.

The Healthcare Commission, in its report to the Government's consultation on the new regulator, accused GPs of making ‘hundreds of errors across the country, every day', and claimed: ‘Prescribing errors occur in up to 11% of consultations.'

Leading figures at the Healthcare Commission have been privately talking for months about how regulating GPs was a ‘top priority' for the organisation, Pulse understands.

Paul Durham, lead for the review of regulation at the Healthcare Commission, admitted the full details had not been worked through: ‘The scale of it is far bigger than anything previously handled, so you'd have to use a risk-based approach, probably with self-assessment and working through PCTs.'

But the proposals caught GPs by surprise, with many taken aback by the extent of the regulator's new powers.

Dr Gary Sweeney, a partner in a PMS surgery in Clacton-on-Sea, Essex, and a GPSI in sigmoidoscopy, said: ‘I'm about to be regulated to hell and I didn't know it.'

Even NHS managers warned the new regulator's powers appeared to be too tough. Nigel Edwards, director of policy at the NHS Confederation, said local managers and doctors feared they would be ‘always looking over their shoulders'.

As well as a range of punishments, ministers propose to publish far more detail about GP performance, as they aim to encourage patients to exercise choice of practice.

The new powers are set to be unveiled as part of the Government's post-Shipman Health and Social Care Bill.

DH Watchdog is armed to teeth Watchdog is armed to teeth

• GPs to register with new regulator, with PMS GPs, GPSIs and those carrying out minor surgery first in line
• Increased monitoring and assessment of GPs, including
regular quality checks and inspections
• Powers to close down services if patients are judged to be at serious risk
• Publication of PCT league tables, with independent assessments of their performance on commissioning

Source: Department of Health

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