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Independents' Day

CQC issues closure notices to two GP practices

Two GP practices face closure from the 1 April after they were issued notices by the Care Quality Commission stating that the regulator intends to refuse their registration.

The CQC told Pulse said there were concerns, either raised by the GMC or by the practices themselves, about the standards at the two practices, but they had been served the notices because they failed to respond to correspondence from the regulator.

A CQC statement said today: ‘To date two “notices proposing to refuse registration” have been issued; the applicants affected have 28 days within which to challenge and appeal against the CQC’s decision.’

The CQC spokesperson added that the CQC hopes to resolve the issues with the two practices before 1 April and that 95% of practices have registered before the 1 April deadline.

The Health and Social Care Act, which comes into effect on 1 April, gives the CQC the power to close practices it has concerns over.

Adrian Hughes, head of registration at the CQC, said: ‘We are delighted with how well GP registration is going; a great deal of work and consultation went into designing a registration process which is as user friendly as possible, and it is good to see this has paid off.’

How has your registration with the CQC gone? Click here to let us know.

Readers' comments (34)

  • Does anyone know what they 'failed' on? I am trying to get some guidelines about the requirements for the inside of my surgery in order to ascertain whether I really have to do all the seemingly ridiculous works that the PCT have ordered. (They admit that these are their own interpretation of the rules). The CQC guidelines are so vague and just talk about safety and suitability.
    I have a modern, purpose built twenty year old surgery and have been told to fit electric doors and rip up all the waiting room carpets. I can't get a definite clear answer from the CQC.

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  • The question is if the CQC closes the practice is the GP partners still accountable for redundancy payments to the staff. Alternatively if we all disengage from CQC what can the government do.
    CQC is of course "delighted" at getting so much money for nothing!!!

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  • #1
    I assume that your PCT has only just "discovered" these issues following transfer of responsibility? If a purpose built surgery 20 years old is unsuitable it seems likely that most practices in the country will have to close for renovation in April.

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  • I wonder who will be required to foot the bill for any changes that may be required to the GP premises that are owned by the PCT? Will the GP be required to find other suitable surgery or just retire?

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  • I am very surprised not many more GP surgeries has been order closed down before just based on lack of hygiene...

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  • If a practice closes because CQC have recommended refusal of registration (and I am sure this will not be done with undue cause - in these cases a lack of reponse and engagement) then responsibiiity for redundancy payments should lie with the GPs as the employer of the staff.

    Patients will expect a GP practice to attain certain standards. Where these are not maintained then the practice deserves to be closed. These standards will never stand still and it is normal part of running a business that things must change at the expense of the business.

    Just go and ask any 'normal' business not molly codeld like a GP.

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  • Surely, the one thing that we could ALL have done to take industrial action without affecting patients in any way, would have been to refuse to register with the CQC. Whydid our leaders not suggest this as a patient-friendly way to express ourselves?

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  • Has the CQC actually been to and inspected said practices or is it just their rumbling beaurocracy and failure of response to paper chase

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  • Bit worrying this, does anyone know where these two are ?

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  • #1 We were told by the CQC staff at their London briefing that they were being used by the PCTs to impose PCT standards that CQC had not imposed (like carpets being ripped up). The PCTs have no say in your CQC registration. For things like carpets, CQC say you are bound by NHS Infection Control Standards, and if you meet these, you are compliant. My understanding of these is that carpet in a reception isn't an infection control risk

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  • We are a modern surgery, built 25 years ago "state of the art" at the time - we have been assessed by Infection Control - and to be CQC compliant are currently having a 300K refit. Just what we need as they tell us that our PMS funding is due to be cut and QOF will make income drop yet further. The refurbishment firm are very happy though.

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  • we have just been told by CQC we are compliant, not been inspected yet so just a paper exercise, BUT my understanding is that you need to do a risk assessment, and if the risk is appropriate you don't need to change things. so carpet in waiting room, as long as you can show an appropriate cleaning regimen and a policy for boldily fluid spills shoudl be ok. ditto toys as long a an appropriate cleaning and replaceent policy......, engage common sense, it is not up to the PCT but CQC and like lots of things they are being blamed for lots which is not them.

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  • I have no intell other than the article above - but it reads as if the practices just haven't responded to the process of registration, rather than any specific issues identified at the practices themselves. That may well reflect problems at the practice. But has anyone actually been inspected yet?

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  • Our practices registration went off the same day I informed the PCT that I have decided to take early retirement.

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  • Comment from the CQC - The CQC does not require any well run and maintained surgery to rip up their carpets, get rid of soft furnishings, rip up skirting boards or do £1,000's of infection control work to their surgeries, this is a myth and one we have been trying very hard to stamp down on.

    If you do undertake any minor surgery then clearly the area where that is performed will need to be clean and infection free and proper safeguards and risk assessments will to take place in that area, otherwise the CQC will not be looking for anything else other than your surgery is well maintained and you do basics to keep things clean.

    Other question around registration can be found here: http://www.cqc.org.uk/register/what-being-registered-cqc-will-mean#wherecanIfindguidance

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  • I agree GP surgeries are a business and should maintain a good standard.

    However the standard hasn't been very clear, and in any case only recently set. As per any business, such changes done quickly will have cost implications and the level of service it provides. The surgery may have no choice but to offer the minial required service as set out in the contract.. Will the patients be happy to see fewer receptionists/GPs/Nurses in their surgeries to accommodate the loss? Or perhaps continual change of staff to employ those on minimal wage? Perhaps partners should seek out cheaper salaried GP from poorer European countries who may be fully qualified to work but has little knowledge of the local culture or language? If we are talking about the "business" in it's pure consumer form, that is what should happen to make "business" sense.

    I hope it wont happen though - I like being a GP and occassionary I'd like to think I might have done a good job and made a difference for my patients, rather than ticking boxes or being a businessman.

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  • Box ticking over patient care anyone? Where are the patients going to go? Do other practices have capacity/want them? The culture of box ticking is all pervasive and increasingly pernicious. Having said which we have also had problems with certain PCT staff spouting nonsense re CQC requirements. They were not too pleased when those of us who had been to CQC info days pointed out that what they were saying completely contradicted CQC information.

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  • i believe cqc requirements for no overflows in the sinks and non fireproof doors in my 200 yr old building will force its closure!!!.

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  • Another possible sanction against the DOH which has
    gone west it would seem. Even less support than last
    year's "strike"

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  • There is a lot of concern about CQC registration especially around premises.
    When they visit they will focus on whether patient safety is compromised and are well aware from the pilots they carried out last year that a lot of primary care is still delivered from old buildings. They do not expect
    state of the art buildings. What they do expect is that practices are aware of any risks and have done something about them.
    They are more than willing to answer any queries and run online Q&A sessions where you can submit your query in advance.
    As long as you can demonstrate that you are meeting the standards (and most well run practices will be able to do so) and can provide the evidence there is no need to worry.
    They will spend more time talking to patients and staff on a visit than looking at documentation so ensure the staff are prepared!

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  • Stuart Calder

    Reading this report and the comments posted subsequently, I have decided that in the past year I have inadvertently found myself in a parallel universe, where the normal rules that govern life in the NHS seem to have become subtly perverted. Much as I try, I can't seem to find any way back to my previous reality, and so the only solution seems to be to adapt or go under.........

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  • so many anonymous reponses!why are most GPs so ashamed they dont use their names!

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  • Richard,

    It is because we try very hard to ensure our agendas and political views are kept separate from day to day patient care but people may take the comments here out of context and accuse us of acting politically, rather than fairy and just.

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  • Get GPs into everything else except seing patients. Can they No to anything.

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  • I agree the ethos of CQC, there should be checks to ensure practices are delivering quality and hygiene etc, I dont agree that we should have to pay for this. I am not worried as I see CQC as a supportive role.

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  • Carpets are not the only issue, but if they can get bodily fluids on them i.e. a child vomiting in your waiting room, then they are an infection control risk. The CQC would not issue these notices lightly, and if the GMC is involved it is likely that there have been significant complaints from patients and possibly staff whistleblowing. Surely 2 out of how ever many there are in the UK is nothing to worry about.

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  • Dr Mustapha Tahir

    The CQC owe a duty to other GP surgeries, to publicise the standards failed by those two surgeries, without mentioning names. That will be helpful to other Practices yet to submit their registration.

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  • I've also read all the previous comments and find the usual mix of common sense and hysteria. If ever there was a demonstration that knowledge is power - this is it!
    Regarding the two practices , it seems that there may also be concerns about them from quarters other than the CQC. If it is true that the practices have not yet engaged with the CQC, I hope that the notices jog them into lifting their heads from the sand and that they get working on sorting out the issues.
    I personally don't have an issue with CQC standards being applied to practices - indeed I think it about time. The vast majority of GP practices will have no problem with compliance, but I have no doubt there are some which could do with a shove in the right direction. Badly run practices let us all down.

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  • Thank you so much to James Hedges from CQC for clarification. I have to say that I did email the CQC for specific answers and did not get them.
    Would've be kind enough to comment on electric doors? We already have double doors and a totally flat entry to the surgery.

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  • CQC would have no issues with having or not having electric doors, if people are able to access the surgery I cant imagine that being an issue that an inspector would ever raise!

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  • What are your views on Infection Control Lead in a surgery ? One Lead Nurse in a single handed GP has tried hard to improve cleaning standards- -- without any success, What can she do ?

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  • It is really useful to have the CQC commenting on this discussion string.
    I would welcome details on the 2 failed practices. It looks as though some people are 'in the know' and have more information than the rest of us

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  • I worte to the local MP to express concern at how the PCT were spending their money refurbishing premises. I had a response and a willingness to visit but the GP who employs me declined, even though the PCT owned premises person responsible declined many of our request and recommendations.

    So what do we have in our nice new shiny refurbishment?

    Door handles that drop off
    Door jams that fall off.
    Panelling that falls down and crushes sink tap
    A computer wiring panel for around my desk, right beneath my examination light!
    Carpeted waiting room
    Screens that open between chair and exam couch
    Bin placed under sink so lid doesn't lift
    No breast feeding facilities
    No isolation facility
    A "kitchen" in recption with no handwashing
    No where to eat away from working desk

    I suppose the CQC will "blame" the GPs who didn't approve in the first place.
    However, we DO have plastic covered wall notices :-)

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  • Re: Jeremy Luke comment: Thank you that’s very kind of you to say so. Regarding the notices that have been served it wouldn't be proper to talk about them in detail as they have 28 days to appeal the CQC decision. However I can say that we had concerns that were either raised on their application or from bodies such as they GMC and despite trying to vigorously contact them to talk though these issues (after which we still may have been able to register them) they refused to respond and CQC was left with no choice but to issue the refusal notices.

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