This site is intended for health professionals only

At the heart of general practice since 1960

CQC specialist adviser quits role due to disillusionment with inspection process

Exclusive A practice manager has resigned as a CQC specialist adviser in protest over the oppressive culture that they say sits at the helm of the regulator. 

Shaun Chadwick, practice manager at Westcotes GP Surgery, handed in his resignation last month after admitting he can no longer work for an organisation whose direction is to 'catch out hard-working GPs who are propping up the NHS'. 

Mr Chadwick, who took up his position in 2015, told Pulse that the current CQC inspection approach is inconsistent and punitive, and has failed to support failing practices.

Earlier this year, in its annual report on the state of health and adult social care in England, the CQC said that a 'large group of GP practices' have deteriorated to a lower rating due to 'ongoing capacity pressures'. 

But in an exclusive interview with Pulse, the watchdog's new chief inspector of primary care said the CQC is 'not going to be making any concessions' for GP practices during inspections, despite acknowledging the ongoing pressures facing the profession.

Mr Chadwick revealed his decision to resign ahead of an upcoming focused inspection after Westcotes GP Surgery failed to comply with a number of regulations. 

He said: 'After years of service at CQC, [...] I no longer wish to be associated with an organisation I don't trust and has such an unjust and inconsistent approach towards regulation.

'It's a shame that CQC can't see that punitive measures and lengthy reports, achieve nothing of real benefit, and are actually counterintuitive by driving people away from the profession thus deepening the NHS crisis.'

Westcotes GP Surgery was rated inadequate in October for not providing safe, effective and well-led services. 

At the time, the CQC team raised concerns over the practice's failure to comply with requirements and regulations, including not having certain medicines in stock and poorly managing clinical cover for annual leave and staff sickness. 

In a series of emails seen by Pulse, Mr Chadwick told the CQC that some of the accusatory points highlighted in the regional GP specialist advisor's report were misleading and incorrect, before he announced his decision to resign as specialist adviser.  

Mr Chadwick said he feared the same specialist adviser might attend the upcoming inspection, which could further impact the practice's efforts to address the 'real concerns'.  

He said: 'Under the new chief inspectors and new regional specialist advisors, I consider my position untenable. It doesn't sit comfortably that CQC's new direction is to catch out hard-working GPs who are essentially propping up the NHS.

'They penalise practices for such things as recruitment issues when in reality, GPs don’t want to be working 14-hour days either, nor is it their fault that there is a recruitment crisis.'

'In my view, CQC is eroding the goodwill of the remaining GP workforce.'

Mr Chadwick said he believes CQC inspectors do not operate under an objective framework when assessing a practice, which in turns leads to 'variation in assessment and inconsistency in the output report'. 

In response, the CQC said the practice had an opportunity to challenge its inspection reports before publication but added it remains committed to working with the staff to help them improve. 

CQC chief inspector of general practice Rosie Benneyworth said: 'Our inspections continue to follow a consistent approach and a clear methodology which was developed through consultation and conversations with the profession and is publicly available. Furthermore, they are carried out by dedicated and experienced inspection teams who work to make sure people have access to the safe, high-quality care that they deserve.'

She added: 'Inspection reports are also subject to factual accuracy review from the practices themselves and are open to challenge before being published.

'These challenges, or any other, were not raised during factual accuracy or by the registered manager of Westcotes GP Surgery, and we will continue to work with them and the practice team in good faith as they work to deliver their clear vision for the surgery which we noted in our report.'

Pulse reported last week that the CQC will have to reinspect almost 70 adult and social care services in England after if found duplicate material in over 100 reports

In July, the BMA called for the CQC to review how they process complaints and inspections, arguing that there is no evidence to suggest 'our system of regulation at a personal level or provider level actually leads to improved safety'.

Meanwhile, the CQC said its new approach of phoning highly-rated practices every year instead of inspecting them as often had helped to 'build relationships between inspector and practice'.

Readers' comments (29)

  • We have direct experience of this. It felt like a ridiculous test where they were only focused on the 1% we were not doing and couldn't really care less about the 99% we were doing right. What test doesn't reward a 99% correct. The inspection felt unfair and completely focused on a tick box mentality. The inspectors spent almost no time actually exploring what was going on in the practice and spent over 90% of the day sitting in two rooms assessing the practice virtually only. A complete and utter joke.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    (1) While one can argue that it could be unfairly judgmental on an organisation by going with one person’s criticism , I would prefer to call this whistleblowing consistent with Murakami’s metaphor of a small egg up against a high wall (of establishment) .
    (2) Without all the details , one can argue that the person was perhaps holding a ‘grudge’ and playing sensationalism . But it is ignominious that a regulatory authority repeatedly expressed bigotry insisting that no mistakes have been made on this matter . It is brazen to ignore any opportunity for introspection under the word of justice to all parties involved and understand the swathe of consequences for every action a regulatory authority would take these days in 21st century .
    (3) As I insist all the time , the only justified ‘way’ forward is the one characterised by transparency, honesty and humility in politics . It is ludicrous that we fail to see these qualities in any of our regulatory authorities( as subordinates of the government) up to this point .
    Blindly defending oneself for the obsession of being the ‘protector’ dominated by certain ego , as well as trying all means insouciantly to prove its value of existence , is repugnant and abhorrent.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    If there is a hard, high wall and an egg that breaks against it, no matter how right the wall or how wrong the egg, I will stand on the side of the egg. Why? Because each of us is an egg, a unique soul enclosed in a fragile egg. Each of us is confronting a high wall. The high wall is the system which forces us to do the things we would not ordinarily see fit to do as individuals . . . We are all human beings, individuals, fragile eggs. We have no hope against the wall: it's too high, too dark, too cold. To fight the wall, we must join our souls together for warmth, strength. We must not let the system control us -- create who we are. It is we who created the system. (Jerusalem Prize acceptance speech, JERUSALEM POST, Feb. 15, 2009)
    Haruki Murakami

    Unsuitable or offensive? Report this comment

  • Snap, did exactly the same 3/52 ago after GP Spa for nearly 6 years.

    Latest gem (among many) from them is around business mileage car insurance and non-reimbursement of my consequent increased insurance premium.

    Due a leaving survey to explain my reasons for resigning.

    Unsuitable or offensive? Report this comment

  • Time for CQC to get it's nose out of General Practice. We are over regulated and subject to scrutiny by CCG, NHSE, GMC and CQC. Really we should only be regulated by the CCG in the same way that the old Health Authorities were responsible for supervising Primary Care.

    Unsuitable or offensive? Report this comment

  • Well done Mr Chadwick

    Please can the other inspectors take note and do the honurable thing so thet we can get rid of these damaging inspections?

    Unsuitable or offensive? Report this comment

  • "honourable"

    Unsuitable or offensive? Report this comment

  • Well done Sir. Any medics working for CQC should hang their heads in shame.

    Unsuitable or offensive? Report this comment

  • The CQC’s role is to standardise practices in preparation for the mass merger in 2024.
    Standardisation: CQC
    Aggregation: PCNs
    Integration: New funds to PCNs only

    You heard it here first. Don’t believe me? NHSE are currently developing ODS codes for PCNs.

    Unsuitable or offensive? Report this comment

  • But they are our critical friends.

    "Listen, you piece of sh~t, this hurts me more than it hurts you".

    In the 14th paragraph, should it not say 14 hours as opposed to 14 days? ( Or are those lazy bast@~d GPs exaggerating their woes again?).

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say