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Independents' Day

GPC asks whether CQC 'can be trusted' after it claims broad support for Ofsted-style ratings

Exclusive GP leaders have asked whether the CQC ‘can be trusted’, after the regulator claimed that there was no opposition to its ‘motivating’ Ofsted-style ratings system for GP practices, despite long-standing warnings by the GPC.

The regulator made the claim in an interim summary report on the consultation about the new inspection regime, but GPC deputy chair Dr Richard Vautrey said it had ‘ignored’ the GPC’s ‘serious concern’ about the new ratings.

He warned the ratings could further deepen the GP recruitment crisis in certain areas of the country by starting a ‘spiral of decline’, while LMC submissions said they were ‘very complicated’ and were ‘aspirational’ in the current climate.

But the CQC said that there was no opposition for the ratings system, and even claimed that they were ‘helpful’ and ‘motivating’ to practices.

Dr Vautrey told Pulse that GPs will ask ‘whether they can trust’ the CQC following the claims and the ‘twisting’ of the practice reports last year, which saw one practice challenging claims that it had an infestation of maggots.

A CQC spokesperson admitted the summary disregarded the GPC submission, but that this was because it was only an interim report, with the full response to the outcome of the consultation to follow in October.

But according to the summary itself, it included all responses from ‘health and social care providers, stakeholders, our staff and members of the public including local community and voluntary groups’ up until the 29 May.

This was after the LMC conference, held on 22-23 May, voted unanimously in favour of a motion ‘vehemently opposing’ the ratings system.

Under the new system, introduced at the end of April, practices will be given 42 ratings relating to six different domains relating to different groups of patients, such as elderly people and children and families, similar to those ratings used by Ofsted for education organisations.

Practices will need to publish these - including an overall rating for their practice - in their waiting rooms and on their website from October, when the system is fully functional following the current pilot period.

The regulator concluded that the ratings element of the new regime had been supported by all parties.

Its summary said: ‘Overall, there have not been major challenges to the features of our proposed new regulatory model. For example, people have not opposed the idea of introducing ratings and many think that having a description of what good care looks like for each of the services we are looking at is helpful and, in some respects, motivating.’

But Dr Vautrey told Pulse: ‘The BMA represents over 150,000 doctors and for CQC to report that they had received no concerns about their simplistic and potentially damaging rating scale is to completely misrepresent the consultation responses.’

‘GPs will question whether they can trust an organisation that twisted their inspection report last year to gain headlines about maggots in GP consultation rooms - which turned out not to be true - and are now saying that everyone supports their rating scale when quite clearly that is not true.’

He added that this will exacerbate the recruitment crisis, which has even hit the practice of Professor Steve Field, the chief inspector of primary care, it was revealed today.

He said: ‘Their rating scale risks making recruitment and retention worse in under-doctored areas as morale falls further with hardworking GPs struggling to recruit to maintain services. Young doctors will not want to risk their reputation by working in practices when there is an official body saying that they are failing. These practices risk a spiral of decline often through no fault of their own.’

Dr Vautrey accused the regulator of ‘spinning’. He said: ‘If CQC are to gain the respect of the profession they need to be open and honest and work in a way that recognises the financial and workload pressures practices are under, and not fall in to the trap of spinning things to suit their agenda.’

The consultation submission from the GPC had said: ‘We have serious concerns about the way in which the CQC rates services. We do not believe that one overall rating can adequately capture the complexities of delivering healthcare and urge the CQC to carefully rethink the way in which rating information is communicated to both staff and the public.’

It was not the only response to raise critique with Cambridgeshire LMC warning that the ratings scheme was ‘overly onerous’.

In its submission, the LMC said: ‘The proposed new system appears to be overly onerous with a very complicated rating process […]Once again, many of the outstanding ratings cannot be achieved without appropriate funding. The ratings process appears to be entirely aspirational in the current climate.’

A CQC spokesperson said: ‘The interim summary published on the CQC website is based on the views of members of the public, providers, staff, local voluntary and community groups (e.g. Local Healthwatch). It does not include the views of larger stakeholders such as the BMA, whose comments, along with more detailed responses from members of the public and individual professionals will form part of our overall response to the consultations which we will publish in October.’

‘The summary on the internet reflects views from events we held across the country for health and social care providers, stakeholders, our staff and members of the public including local community and voluntary groups that represent them.’


Readers' comments (7)

  • Whats interesting is that if you go through the practices of some of our GP leaders - in particular those who sit in NHS England. Many of them have practices in severe trouble.

    Some how though they seem to be able to pontificate very easily without sorting out the home turf!

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  • I agree with the above.

    How can I trust CQC when it's chief inspector de-registers NH patients to cut his work load?

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  • Mark my words this talk of crisis in primary care is exactly what the government/civil servants want and we need to be careful.
    We and I include the RCGP and GPC are being extremely naiive.

    It does not matter which party gets in next year there is a concerted effort to undermine the profession and fan the flames of a crisis right up to the election. This is being driven by Whitehall.

    It is clear that we are building up to a 'mid staffs' event in Primary Care probably soon after May 2015. This will result in a huge and costly public enquiry led by our friend Prof Field which will conclude the only real way to address the lottery of care, lottery of access and and variable quality in Primary Care is to reform independant contractor status.

    While huge practices such as mine will be offered opportunities it is clear the opportunties will sit with Virgin, The hurley/ Gerada group and The practice Plc, Circle and the Foundation trusts

    The denigration of the profession, the fact most of my highly talented colleagues are retiring, working part time or heading to Aus/ Canada in addition to a primary care mid staffs expose in mid 2015 will break the back of traditional general practice forever.

    The problem is the public/patients on the whole will not realise how good they have it until they meet the corporate driven model of general practice.

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  • You have to ask who wrote the CQC report. The Chief Inspector does not believe in rating general practices except along he lines of pass and fail - for those practices falling way below acceptable standards. The rating system has clearly been imposed by the Secretary of State for Health.

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  • 1. GPC will oppose and huff and puff
    2. CQC will do it anyway
    3. GPC will fold and say 'we did our best'
    4. months later LMC will put a motion on a vote on 'considering' to do something about it. The motion will be rejected as they don't want to rock the boat.
    5. BMA will moan about it but cite legal reasons why nothing can be done.
    5. RCGP will say its a good idea as it could theoretically benefit a single patient in Milton Keynes (under the right conditions)
    6. GPs will get fed up and leave
    7. prospective trainees will have another reason not to join
    8. start back at 1 but replace 2 with idea from doh, nhse

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  • Ha ha 9.15pm that is fantastic.

    And worryingly it could be applied to any Dept of Health / CQC / NHS-E initiative.

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  • I also love 9:15pm comment thank you! This really feels like another nail in the coffin- can they not see we have a recruitment and funding problem that will only get worse if they continue to demotivate us and make it harder to do our jobs? Politicians whether MPs or in CQC etc should listen to real facts and evidence not what they want to hear. Remember the recent Commonwealth Fund report- we are cheap AND effective!

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