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CQC plans for inspectors to sit in on GP patient consultations

Exclusive CQC inspection teams may sit in on GP consultations as part of the new inspection regime being rolled out this year, Pulse can reveal.

The CQC told Pulse that this would form part of new methods of gathering evidence when inspecting GP practices and will feature as part of the pilot inspections that will run up until the formal launch in October. Although inspectors will not sit in on consultations as part of every practice inspection, the CQC said it ‘reserved the right’ to do so.

Reacting to plans, most GP leaders said the move was ‘a step too far’ and also not the role of the CQC.

GPC negotiator Dr Beth McCarron-Nash said: ‘It’s wrong, I don’t agree with it at all. It’s the role of the GMC, not the CQC, and they’re overstepping the mark.’

Dr Robert Morley, head of the GPC contracts and regulation subcommittee and executive secretary at Birmingham LMC, said: ‘I personally feel it’s wholly inappropriate, regardless of patient consent. There is a world of difference between, for example, Ofsted sitting in on a teaching lesson and an inspector sitting in on that most confidential and intimate encounters, the consultation between a patient and their doctor.’

‘There are all sorts of issues. A patient might feel pressurised to consent, either to support their GP or to support the inspection process. The entire nature of the consultation would alter, making it highly unlikely that CQC could gather any truly meaningful information from the process and it is hard to envisage any situation in which CQC should do this in a routine inspection.’

Dr Morley added: ‘It really would be a step to far and, in all honesty, if this does start to happen I do hope the profession as a whole would rise up and refuse to accept it.’

A CQC spokesperson told Pulse: ‘Observing care is one of the ways that we can gather evidence, in addition to reviewing records, policies and other documents, listening to staff, and pathway tracking patients through their care.’

‘This means that members of our inspection team reserve the right to sit in on consultations as part of their visits – this would be on rare occasions and if we felt it necessary and of course, we would obtain the necessary consent from patients beforehand.’

But Dr Andrew Mimnagh, a GP in Sefton and the former chair of Sefton LMC, said one upside of CQC sitting in on consultations would be to GP development, similar to Ofsted inspections.

He said: ‘That is what teachers get with Ofsted, they get the observation of their lessons, they get the feedback on it and they do get developmental and improvement feedback.’

The CQC published a 100-page handbook on the new GP inspection regime last month, setting out requirements for achieving the new Ofsted-style ratings that will see practices marked as ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’.

These four ratings are based on 42 separate performance standards, which practices will be contractually required to publish alongside their overall rating in the waiting room.

Speaking at the Pulse Live conference in London earlier this week, Dr Morley warned of the extra stress and workload that the inspections would cause.

Readers' comments (46)

  • Do patients get a choice in this ? I'm sure all of mine would refuse to take part . Especially after I've asked them to refuse .

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  • I always thought it would be useful to have a period once a year or so where consultations were observed for formative feedback, but doing it for summative reasons is entirely different.

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  • Do it for revalidation and scrap the rest

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  • kafkaristic crap

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  • what is the purpose of this?

    how much will it cost?, who is going to do it (layperson or a GP)?, why do it when we have re-validation?, how will it be done i.e. how is the feedback going to be presented?

    I'm sorry but I think this is not going to help costs, moral, retention or recruitment.

    I've got revalidation in 2 years after that it's private practice or a change in career !

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  • This is all getting a bit silly. Anybody who thinks this is about patient care is deluding themselves, HMG are abusing their power as such a scheme will provide the perfect cover to shut down dissent. It's time to leave the NHS.

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  • If I where a patient I would walk out and rebook for a different day as if you refused consent CQC may read the records without patient consent of that consultation.

    Will they sit in on dental consultations too I wonder or is it just GPs that are to be targetted?

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  • Bob Hodges

    Erm, No.

    Next question?

    Sanctions? Bring it on!

    A 'needs improvement rating?' Whoop-de-doo!!

    Shut the practice? A blessing in disguise!


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  • Where will it all end?......CQC demands strip search and body cavity examination to ensure not smuggling drugs as this could impact on patient safety

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  • Azeem Majeed

    The CQC may make mandatory written consent for medical students to be present in GP consultations. This is an issue that Primary Care departments in universities are currently considering.

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