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CQC says GPs should be more involved in end-of-life care

The chief inspector of primary care has indicated that GPs could ‘do better’ when dealing with end-of-life care.

Discussing the issue at the CQC’s Board meeting yesterday, Professor Steve Field who is chief inspector of general practice, said that GPs were integral to end-of-life care and were involved across the board.

But Professor Field said ‘we could do better as we move forward’.

He suggested that more could be done to ensure that GPs were the essential link between practices, hospices and hospitals for patients approaching the end of their lives.

Professor Field’s comments come as end-of-life care hit the headlines in a damning report by the Parliamentary and Health Service Ombudsman earlier this week.

‘Dying Without Dignity’ revealed several examples of where patients and their families had negative experiences at the end of their life due to such things as poor communication, a lack of out-of-hours support and a lack of recognition that the person was dying.

In the same meeting, chief executive David Behan told the CQC Board that, as of 8 May, 826 GP inspection reports had been published, with 25 rated outstanding, 678 rated good, 92 requiring improvement and 31 rated inadequate.

It comes the day after GPC called for the CQC inspection ratings to be abolished.

Readers' comments (22)

  • stop surgeries getting clogged up with worried well and runny noses and well be able to be more proactive with the ones who suffer in silence

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  • Stop wasting our time with CQC inspections and Revalidation nonsense and we would have more time to look after poorly people.

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  • Prof Field
    I am afraid you have zero credibility amongst grass- root GPs
    If you as a so called leader of GPs looked at the issues that prevent GPs from taking a bigger role in the areas that we all want to do ie palliative care chronic disease management etc.
    you should be contributing to resolving the issues as to why we are so overworked, underfunded ,politically bounced around rather than adding to them with a regime which everybody well knows will make no difference to quality and safety but only makes things worse

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  • "GPs are ideally placed to...", "GPs could do more with...", "GPs should do more in...". Every bandwagon has their own proposals and they are all good but they need to tell us what we are going to stop doing so we can do more with their particular area of interest. Was at an asthma conference the other day and staggered by the lack of generalism in the room. If we did everything they said there that we should do as "minimum standards", we'd never do anything but asthma management.

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  • Like I suspect a lot of other GPs I used to do a lot of palliative care work, including daily visits ( sometimes multiple times a day) This has largely stopped in the last few years.
    1. Because the general workload has increased to such an extent that there just isn't time any more.
    2. The "palliative care team" have pushed us out and made it clear that they do not want us interfering except to sign whatever they ask.
    3. The move towards " protocols" and a "care pathway" has removed a lot of the supportive personal discussion and care that we used to give. Any deviation from this is frowned upon and liable to be criticised by team members who may well never have met the patient before, even if we have known them for 30 years.

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  • No - that's what a palliative care team is for. Shall GPs do ogds, angiograms and bronchoscopies too? Just a ploy to act as a mobile district nurse/social service,/charity all in one.

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  • What does Steve Field have to do with how much we do end-of-life care?!

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  • Dear Prof
    When you have a dying patient do you contact everyday and be more involved?
    What's that - no, you only work 1 day a week in GP.
    Sod off with your ideas that do not stack up with the full time GP with a full time patient workload.
    Of course it's important but so is everyone elses agenda.

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  • Like my GP monthly in Medway yesterday where the clinical officer threatened gps- ''patient will sue you if he gets a stroke and you haven't checked his bp' ha ha ha my foot:)

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  • if it's the CQC that's ending it's life - i'll be there in a flash !

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  • Another piece of cloud cuckoo obvious predictably impractical tosh from a 20 per cent full time academic who most grass roots go would like to resign from the ludicrous delusional quango that needs to be abolished
    Then the prof could help real patients and the cqc funding could be used to genuinely improve care rather than waste the time of and irritate the 😖out of real gps as opposed to those obsessed with their own self advancement.
    Sorry but 95 per cent of real gps looking after real patients feel the same
    And personally I am incandescent with anger at the ignorant arrogance of those who either do not do the job or who just play at it saying gps should do this that or the other
    How utterly disgraceful to criticise colleagues about their palliative care
    That is an insult that makes me furious
    A period of silence from certain academics would now be most welcome

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  • Thanks @10.03pm
    From one among the 95%

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  • Well, I can completely understand where prof field is coming from.

    After all, CQC is heavily involved in end of primary care's life.

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  • We do over 75 % of all face to face NHS consultations on 6% of the budget, here in NI.We see over 45 patients a day in 10-12 hours. But, of course, it is never enough.
    Never enough for the Obese or Diabetes or Asthma or Hypertension or COPD or Dementia and so on and on.
    It is never enough.
    But it is our own stupid fault, because we do not, as doctors ever define what enough is. What is safe practice ? how many should I see in a day ? how many consultations,blood tests,letters and on and on.
    I am glad to see some thinking on payment per item mixed in with block Contracts.
    Till we define safety in numbers per day, we will NEVER EVER do enough.

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  • Jmd

    I feel we need a mature debate. I agree the statement by Prof.- we can do more! However, whatever we gps do has to be under the umbrella of safe practice.
    I have been in GP long enough to recognise the ever increasing workload and tick box exercise is becoming to a rate limiting point where safe practice is becoming an issue. We really need more GPs and defined working hrs to provide a safe proactive service to our patients and they deserve it.

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  • Could do better? Right back at ya Prof, your clipboard wielding army could certainly do a lot better. Imagine if they were all seeing patients rather than checking whether my reception staff know what a tiger stripe refuse sack is used for ( aside from suffocating anyone who asks).

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  • Payment by contract means privatisation
    Think about it
    What ever we do it will fail , we are set up to fail sadly
    Call it Doom and gloom but the facts are the facts
    Let's see hmm who do you think will really benefit in the long term , it's the insurance agencies .
    I have heard unofficially in a bar in international air space about an example of one company called United health checking Dr and scrutinising Each and every step , and along with I have heard the UK insurance providers thinking about employing Drs to work for them and guess where this will lead
    The above is an opinion of people whom I overheard as they were speaking loudly in international airspace and any resemblance to anything fictional or non fictional is purely coincidental

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  • Bit of a coincidence Simon Stevens head of NHSE worked for United Health so will be here soon.

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  • Our contract values hundreds of useless avoiding hospital admissions care plans over actually seeing the palliative care patients as identified by primary care.
    Pitty the good prof offered no evidence as to what GPs aren't doing that he thinks we should be doing - all GPs I know value palliative care, particularly as it's one area where tick boxing and clipboards haven't taken over in our area.

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  • CQC do not know what they are talking about - the GPs are already involved in end of life care in fact more often than not co-ordinating it

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  • Privatisation was all but completed by the Labour Party in 2004!!

    They just called it "independant Contracting," but that is just a play on words.

    Get used to it, the "Free" NHS is no longer affordable.

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