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Revealed: Only 44 CQC inspections since July last year included a GP on the inspection team

Exclusive Only a handful of more than 800 CQC inspections of GP practices conducted last year included a GP on the inspection team, figures obtained by Pulse reveal.

GP leaders say the figures - released for the first time by the CQC after a request under the Freedom of Information Act - devalue the results of the inspections that have already taken place.

Those inspections have been subject to intense media scrutiny, with one practice being famously hauled over the coals for maggots that were found on the premises.

The CQC’s response said that since July 2013, 468 inspections of primary medical services - including GP practices, dentists and community services - have included a ‘specialist adviser’, and that in 44 cases this was a GP. Over that same period a total of 816 practice inspections took place.

Since April 2013, the regulator said it had conducted ‘around 1,000 practice inspections since April 2013, including 90 follow up inspections, but figures for the use of specialist advisers were not available for the first three months of the programme.

A CQC spokesperson said that from April this situation would change. He said: ‘From April 2014 inspection teams will include a CQC inspector, a GP, a practice nurse or practice manager and a trainee GP. They may also include a member of the public with particular experience of using GP practices.’

Chief inspector of primary care Professor Steve Field told Pulse in November that the CQC inspection process was ‘slightly flawed’ because there were not GPs on ‘all’ visits, and has vowed to include a GP presence on all inspections under his new regime.

Responding to the new figures, Professor Field told Pulse that although GP input will lead to a broader process, the inspections thus far have been of value.

He said: ‘I’m a GP and I have been involved in inspecting practices for years. When I learnt about the detail of the current CQC model, it became obvious to me that we needed to change it and have more clinical input.

‘[But] it also became clear that these inspectors that were trained were finding important deficiencies in some practices. Those are important and we have published the reports because we are an open and transparent organisation. It does not take a doctor to see that a fridge is not being monitored for its temperature, or that vaccines are out of date or in some cases that emergency drugs are out of date.’

He added: ‘But what will happen is that the clinician on the visit - the GP - will be able to look more broadly and we are looking at the exact content and process of those visits today and will continue to do that until when we pilot them in April.’

But Dr Peter Holden, a BMA negotiator, said that despite the welcome changes due to be introduced, the results previous inspections were still being used.

He said: ‘I don’t consider the process to have been fair or reasonable. General practice is a specialist operation. How an inspector can one day be doing nursing home or a care home the day after a tattoo parlour and a general practice beats me.’

‘The process is going to be changed, and there will be a GP in there, but if I was one of the practices that had an adverse report I would say I expected to be judged by my peers by someone who knew what they were looking at.’

Dr Peter Goodall, a GP in Southampton, said his single-handed practice received a call from the CQC last week admitting they had little experience of smaller practices.

He said: ‘Our practice manager took the phone call and the CQC said the local team is used to larger practices and they are not used to single handed practices so, reading between the lines, they were saying they will be learning from the experience as much as we will.’

Readers' comments (5)

  • What a shambles.

    Still, obviously a Trainee GP (ie someone who hasn't actually worked in the field in a substantive post) will make all of the difference. NOT.

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  • Including a GP will be a helpful addition to a CQC inspection team, and will bring to play a wider dimension - but it is missing the whole point of the CQC to suggest that inspections are worthless without such clinical input. The CQC exists to ensure that a wide range of "minimum" standards are being met across the whole of health and social care. Such inspections already apply routinely for every other CQC registered organisation, in addition to GP Practices. And most of these criteria do not in fact need a highly paid and experienced professional to be present in order to assess them (as Professor Field indicates).

    It would be more helpful to have professional views about the added-value that a GP can bring to the monitoring and inspection process - and how this can contribute to the huge challenge of levelling up standards across different practices so that all can emulate those of the best of UK primary care.

    Richard Banyard
    CQCassist.

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  • The comment re the GP registrar misses the point - the plan is for there to be a trained GP on a visit and just like for our hospital inspections there will be a trainee ie GP Registrar - partly for professional development and partly because they will be a great asset to the team as they have at least 9 years in medical training and experience shows they ask very incisive questions without the baggage perhaps of being a GP Principal - there will of course also be nurses and patients

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  • 9 years medical training…

    6 years in lecture theatres or on the wards, a couple in secondary care as FY1/2 and at least a couple of months (at best) in GP. They should be inspecting hospitals not somewhere they know little about. Then again having GPs who see patients most days running CQC etc would be pretty useful too.

    Who is going to see the patients when "trained GPs" are inspecting? Who is paying for the locums? Or will it be like all the other "trained GPs" who sit on various groups and committees etc and do 1 or 2 sessions per week at best?

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  • The GPs do not necessarily want to be involved in doing inspections of which on the whole do not bring benefit to patients - it might be more appropriate to have a practice manager who at least understands the proposed purpose of the visits much as the deanery do when deciding whether or not a practice is a practice they feel is appropriate to train the next GPS - that would be sensible approach and then the GPs could continue to look after patients instead of yet another box ticking exercise

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