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CQC overhauls risk rating indicators as GPC declares scheme a 'shambles'

The CQC has overhauled a number of indicators used in its risk ratings scheme, which GPC has said demonstrates the continuing ‘shambles’ of the intelligent monitoring initiative.

The regulator has announced on its website that it is changing indicators relating to the GP Patient Survey meaning that 60 practices given a initial risk rating of 1 or 2 will now be declared to be not a potential risk, and will be informed on Monday.

However, seven practices will also be given a higher risk rating as a result of the changes.

It comes after a huge backlash from the profession after the CQC published the ratings on almost all practices in England, based on QOF data and the GP Patient Survey, which was picked up by national and local media.

Pulse reported there were concerns over the accuracy of much of the data, including for those practices that had dropped elements of QOF and for the indicators relating to the patient survey.

The CQC said it was reviewing the indicators with the Department of Health and the GPC, and as a result it has revised five of the indicators.

The indicators that have been reviewed are:

  • The proportion of respondents to the GP patient survey who stated that the last time they wanted to see or speak to a GP or nurse from their GP surgery they were able to get an appointment;
  • The number of emergency admissions for 19 ambulatory care sensitive conditions per 1,000 population;
  • Ratio of reported versus expected prevalence for COPD;
  • The ratio of expected to reported prevalence of coronary heart disease;
  • Dementia diagnosis rate adjusted by the number of patients in residential care homes.

Professor Nigel Sparrow, senior national GP advisor and responsible officer, said: ‘Following feedback from national and local stakeholders, and working with NHS England, we have now completed a comprehensive review of the data and, as a result, there are a number of changes.

‘The vast majority of GP practices will not be affected by these changes. Overall, 60 practices (less than 1%) previously in higher priority bands 1 and 2 will now move to bands which are of lower priority for inspection. We will contact each of those practices to apologise for any concern this may have caused GPs, their staff and their patients. We will also contact the seven practices which will move into a higher priority band as a result of these changes. Updated IM reports and more information will be available on our website from Monday.’

He added that the CQC wanted to ‘reinforce the message that the banding is not a judgement’. Professor Sparrow said: ‘Intelligent monitoring will never be used in isolation to make a final judgement or produce a rating of a GP practice.’

However, Dr Richard Vautrey, GPC deputy chair, said this was another part of the ‘shambles’ that is the CQC’s intelligent monitoring scheme.

He told Pulse: ‘The reality is that this is a shambles and the CQC should have listened to us before releasing the first set of information. We called for it not to be published in advance and they ignored that.

‘They have agreed to work with us on developing a new system but it seems crazy to be tinkering around with something that is fundamentally flawed and has seriously damaged the reputation of many good practices and good GPs.

He added: ‘They should be withdrawing this flawed banding system.’

Readers' comments (32)

  • What possessed them to publish their pre-judgements anyway? Internal strategy should have remained just that until/unless validity was proved. I think we all know how little publicity the revisions will receive cf the previous headlines

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  • Vinci Ho

    Is it more appropriate to apologise openly than messing around with the ratings?
    Remember what GMC said about we should apologise to our patients if indicated ??
    SF should speak in an open press conference to explain all these to the public .

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  • All the Einsteins on the planet in one group - NHSE and CQC. Also Doc Holliday, John Wesley Hardin and Curly Bill Brocius together- shoot them dead first, ask questions later. This shambles actually reflects the IQ and EQ of Prof Field and Sparrow. Please make up your own minds on these levels.

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  • So glad that we reported problems to CQC re GPPS005 on 17th November - reassured that they would respond in 10 days - Hadn't realised they really meant we could read about it in Pulse after 15....

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  • Professors Field, Sparrow and Merion Thomas. It is not enough that we do see 92% ON 8%. We are done for.

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  • It is too late, the damage is done.
    Field needs to resign.

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  • I should be angry and surprised, but those feelings are dwarved by the sadness that so few can upset so many, so easily through incompetence

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  • The sad fact is that I am not surprised, it is exactly what we have come to expect over the last few years.
    Rubbish spouted, not prepared to listen to reasonable arguments, shown to be incompetent and have their own political agenda, and then, when they are proved wrong, they refuse to apologise and move in to the next debacle.
    I honestly don't know of any other group who has been treated so badly for so long and cannot imagine why people put up with it.

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  • Shamelessly damaging professional reputations built up over many years and then lamely apologising. Steve Field needs to resign.I really can't see that he can continue. If he clings on then we need a petition of no confidence.

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  • How are they going to compensate affected practices in terms of time spent explaining this nonsense to patients and also the loss of reputation...? Clearly the revised scored are not going to make the front pages of the papers....

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  • Lets get every GP to personally contribute a small sum to a fund , lets get ourselves a Barrister and sue for defamation.

    I suppose in the old days this would have been handled by our beloved GPC

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  • See http://www.bbc.co.uk/news/health-30344455

    Strange how the Chief for HOSPITALS comments:

    Sir Mike Richards, chief inspector of hospitals for the CQC, has stated "We will make them [GPs] a big apology. This only became apparent when we ran the data on the thousands of practices rather than just the hundreds that we tested them on."

    --
    Either Steve Field is on holiday or he is in for the chop.

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  • Are the CQC deluded as they persist in calling this monitoring intelligent? Or are they using the term because they see it as espionage or do they think they are drawing battle lines? They remain unfit for purpose. QED.

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  • Siraj Shah

    QOF is a voluntary tick box exercise that is open to manipulation therefore a high QOF score does not necessarily equate with high quality care.

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  • Richards indicated on the Media that CQC had colluded with the BMA and the RCGP for this exercise.
    Our Professional bodies should totally disassociate themselves from this flawed QUANGO.

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  • What an absolute shambles. Prof Field has no credibility and should go. The damage to these practices has already been done and the CQC should never have published this in the first place. Shame on the GPC once again for not standing up for grassroots GPs.

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  • 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?

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  • can anyone get a class action here and let the lawyers loose on these incompetents? is the Sparrow compliant with GMC requirements in his dealings with the profession? anyone?

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  • Macavity, Macavity, there's no one like Macavity,
    He's broken every human law, he breaks the law of gravity.
    His powers of levitation would make a fakir stare,
    And when you reach the scene of crime—Macavity's not there!
    You may seek him in the basement, you may look up in the air—
    But I tell you once and once again, Macavity's not there!

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  • Professor Field need to resign

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  • Anyone know where those traitors Steve Field and Nigel Sparrow are hiding? House of Lords lobby?

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  • CQC state the "the banding is not a judgement". If this is the case, why release the information (to the media and the public) in such an inaccurate, misleading and sensationalist manner? The head of CQC should be held accountable for this, and as well as resign, should be investigated by the GMC. He brings the whole of the profession into disrepute. Doctors have been struck off for less damaging crimes.

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  • surely if the CQC ratings have been discredited then as a professional body we have lost confidence in the CQC. The only way to change the inspections is a national campaign of non co-operation until the inspection criteria are changed and have become more reasonable and measured

    The inspections are really designed to make it virtually impossible for individual practices to survive which ultimately is the government agenda anyway

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  • A class action by those practices affected. Mass resignation from the NHS a month before the election would focus the minds of the politicians. Alternative model: co payments and an insurance backed system like the rest of the world. This would protect patients in the long term. To carry on with this pantomime while politicians and the public bury their heads in the sand is not an option. The bond markets will get spooked soon and stop selling UK plc cheap debt. Need to do something before then if at all possible. Country is bankrupt and shortly the CQC will be the least of our worries. Talk to the Greek health workers who did not get paid when their system and country went bust to get an idea of what awaits us all. At least with a copayment model we will be able to feed our families.

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  • I looked at the CQC website - and couldn't find any announcement, explanation or correction for this omnishambles.
    I appreciate that communication doesn't seem to be a strong point among the Poawers That Be in the new NHS (I could also cite NHS England with care.data as an example) but if CQC is apologising to GPs, shouldn't this be somewhere prominent for *patients* (and the media) if they want to check up on their practice?

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  • Do you think anybody care? The purpose of forming NHSE was to bankrupt the system and squeeze GPs out.
    The purpose of CQC was lethally damage the morale while squeezing out more cash form Practices and to make sure that NHS bosses do not lose weight.
    Mission accomplishment a step closer.
    Vote this government back and you might as well write your will today because tomorrow there won't be workers left in this country- and I am not talking just of the Health services.

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  • @10:48 -
    ''Prof'' Steve Field claimed he was offered the job of forming/re-forming the NHS Constitution by Cameron himself. I bet CQC Chair was also given to him by Cameron himself.
    Like all the guys with multiple hats - whether CQC, BMA,NHSE or LMC - these guys need some serious CBT !! Wonder whether Cameron is not going to head an American Healthcare Co in UK after he loses elections.

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  • Satirical headline: ''CQC HARMS PATIENT CARE''

    'practices spend so long jumping through hoops and dreaming up policies and procedures that patient appointments are cancelled as partners move to managment roles within practices to deal with the bureacracy that CQC generates'.

    Satire? Or is it?

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  • Dear Ed,
    What's the relevence of a pictue of a condom under the CQC picture?
    I can think of plenty of things that'd get moderated about shafting etc.....

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  • Like other faceless quangos run by unaccountable feckless individuals they ***s tax payers' money up the wall and nothing ever happens to them. They think they are immune from being sued and cannot lose their own personal wealth. Broken Britain. Broken by unpleasant bafoons who move from one feeding trough to the next.

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  • unfit for purpose unelected quango cqc.
    completely lost confidence of gp body.could only retain it after resignations and apologies.

    field must must resign over this...anything else would lack honour.
    cqc has failed the profession by grossly unjustly slurring many hard working practices in such a careless and callous manner.
    faceless unaccountable tick box jobsworth callous bullying organisation.
    yet another reason for the whole gp body to threaten resignation..i think it is time to bring this utter shambles of a theatre... cqc nhse and all the other useless bodies to an ignoble end.
    for cqc to say this is 'intelligent monitoring' is pure 1984 nonsense language..parody become depraved reality...beyond unbelievable..just WHO are these people?

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  • Speaking as someone who works at the CQC I am surprised at the lack of understanding there is around the 'Risk bandings', I take it that nobody who has commented here took the time to read the extensive guidance issued with the first 'Intelligent Monitoring' for Primary Medical Services. I suspect that some of the comments made in here will do far more damage to GP reputations than a miscalculated indicator. The decision to publish these bandings (not judgements) was to give some transparency to how we go about inspecting GP practices, and judgements only come from inspection. I had thought that such highly educated professionals would have understood that better. I have read more articulate and thoughtful posts from my teenage nieces and nephews on facebook.

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