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Independents' Day

GPs to publish grid of 42 different Ofsted-style ratings in waiting rooms

All GP practices will be given 42 different CQC ratings as part of proposals for the regulator’s new-style inspection regime, which they will have to publish in their waiting rooms as a contractual requirement.

The CQC released its 100-page handbook yesterday, which sets out how practices will achieve ratings of ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’ - a system that has been likened to the Ofsted-regime for the education sector.

The consultation period finishes in June, and will be informed by the first wave of inspections, which begin at the end of this month. Practices will be given ratings from October onwards.

It reveals that practices will be given ratings on how well they treat six different ‘population groups’: older people; patients with long-term conditions; mothers, babies and children; the working age population; people in vulnerable circumstances such as the homeless; and those with mental health problems.

Practices will also be given ratings for how effective, caring, responsive, safe and well-led they are - five ratings in all.

Finally, they will give practices ratings based on how effective, caring, responsive, safe and well-led they are for each population group - totalling 30 more ratings. All together, this will inform their single overall rating.

As part of the 2014/15 contract settlement, it was agreed that each practice should display their ratings in their waiting rooms and on their website.

The handbook says that inspectors should follow key lines of enquiry (KLOES) for each domain. For example, in the safety domain, questioning of practices will focus on how well they have learned from previous safety incidents, safeguarding, and staffing levels and suitability. The handbook sets out prompts for inspectors in each of these areas.

Practices will also have to demonstrate ease of access to out-of-hours appointments as part of the assessment of their care for working age patients.

They will be able to appeal their ratings under the terms set out in the Health and Social Care Act. They will also be able to take any CQC decisions they are unhappy with to a first-tier tribunal.

CQC chief executive David Behan said: ‘Over the past six months we set out proposals for different types of care services and we have been testing our new style inspections in hospitals, mental health and community health services and will be testing them in adult social care services and GP practices from this month.’

‘The changes we are making are vital to ensuring that we are able to make sure that health and social care services provide people with safe, effective, compassionate, high quality care and encourage care services to improve. Throughout these changes, we will always be on the side of people who use services and it is important to us that we hear what people think of our plans.’

Health secretary Jeremy Hunt said: ‘A new, independent and rigorous inspection regime will give the public vital information on health and social care performance, and the chief inspectors will shine a light on areas where improvement is needed. The CQC is seeking views on important elements of their inspection programme and I would encourage patients and all other interested parties to respond. This will help to drive up quality.’

The summary of the changes to the contract this year state: ‘It has been agreed that when the CQC new inspection arrangements are introduced from October 2014, practices will be required to display the inspection outcome in their waiting room(s) and on the practice website.’

‘These changes will be implemented through changes to the CQC regulations meaning the requirement will be on GP practices as a registered provider rather than as a requirement of holding a GMS contract. Further details and guidance will be available once the regulations have been finalised later in the summer of 2014.’

CQC rating infographic




Readers' comments (14)

  • So we are to be judged on how well we do non-contractual work then?

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  • Will there be any indication as to wether the government has actually paid for all the services it's telling people to expect?

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  • Took Early Retirement

    This is a little missive we are sending to patients. Things like the above are just what has made us walk!

    Dear Patients,

    After nearly 30 years at Victor St Surgery, John Glasspool and Jill Graham (Mr & Mrs Glasspool in their home lives) have decided to call it a day and will be retiring at the end of May. In many ways we shall be sorry to go, since over time, many of you have become like our chums and we shall miss you greatly. Sadly, over the last 8 years or so, governments of both parties seem to have had it in for General Practice and have been making the job more and more difficult, demanding “more for less”, and increasing the burden of administration and inspection. It is a matter of public record that Primary Care is receiving a decreasing proportion of the NHS's funding, whilst being asked to take on more work from hospitals. This cannot go on for ever, and we both feel that we would shortly be in the position of not being able to do our work to the standards we would like.
    You may have noticed that there has been a campaign of vilification against GPs in some sections of the press for some time now. It is so persistent that we can only assume it comes from government. Under the circumstances, a lot of GPs in their 50's are doing the same as us.
    We wish you all the best for the future.

    John & Jill

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  • Good for you, Glasspools. Good luck.

    If only some of our leaders could get the message across to the public as well as you have.

    I am only in my early 40s and it makes me feel so despondent wondering what bull is coming next. Why can't they just leave us to do our jobs?

    The stated aim of this kind of thing is to drive out bad practice. Well, it also drives out good practice as the Glasspools will attest. Soon there will be no GPs left.

    I suspect this is mostly to unsettle GPs, make us less united and easier to bully about.

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  • The press-especially The Daily Mail-have been "terrorising" GPs. There is far more anti-GP rhetoric than anti-banker, yet it is the bankers who caused the credit crunch.
    The Government always resort to the same tried and tested tactics.
    They use their friends in the press to "terrorise" anybody who they think needs "softening up".
    In return, the press are shielded from any form of regulation.

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  • My advice to any Nurse or practice manager (its usually really fed up nurses and practice managers who decide to become CQC inspectors) is pack in your day job and you can have a very cushy 9 to 5 Monday to Friday job visiting practices and doing these CQC reports rather than slaving on an acute ward or delivery suite or running round your staff asking for written protocols for everything that have been doing for years.
    Meanwhile hard pressed and stressed up partners who are at the peak of their game are retiring in droves

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  • Things like this are why I am no longer a Practice Manager nor an NHS patient. Its just so depressing what is happening to General Practice.

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  • Not sure how they look at treatment of "homeless" people as they have all been wiped out on the NHS ghost patient removal scheme and cannot register any new patient without an address! and the "homeless" are actually registered at their relatives address and now difficult to find out except by "tribal knowledge" by partners.
    Very often this means we have several DNA`s for hospital appointments which has wasted more money per punter than by the £62 saving they aim to have achieved by removing these patients.

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  • Good luck to you John and Jill..maybe this something more retires should consider doing when they go. All the best to you

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  • Well Ofsted has done great thins for improving standards in schools, maybe this is needed.

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