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Practices placed in CQC ‘special measures’ could face bill of up to £5,000 to be given support

Exclusive GP practices that are placed in CQC ‘special measures’ will have to pay half the costs of essential support, which will cost them up £5,000, in a move described by GP leaders as potentially the ‘final straw’ for many practices.

The 12-month pilot support programme developed by the RCGP and NHS England has been offered to practices that enter special measures after being given a rating of ‘inadequate’ in some areas by the CQC’s new inspection regime, and will include expert professional advice, support and peer mentoring from senior GPs co-ordinated by the college.

Earlier in year, Pulse revealed that practices would have to pay a fee if they want to access the support package, and Pulse has learnt that the cost will be up to £5,000, which will be matched by the practice’s respective NHS England local area team.

But the GPC has warned that practices most likely to need the support will be under-resourced, with this extra fee potentially leading to practices closing.

NHS England has revealed that the pilot will only be available to practices which are placed into special measures between 1 October 2014 and 30 June 2015, and the pilot will end in October 2015.

RCGP’s support team will also draw up a tailored plan for each practice in the programme to support them in making ‘significant changes to improve their services’.

The RCGP support team’s focus is likely to include:

  • Helping the practice understand the problems identified by the CQC
  • Support the practice to develop an improvement plan (or refine their existing plan) to address issues underlying the problems identified by the CQC
  • Provide direct advice and mentoring to GPs, practice managers and other staff as they work on improvements
  • Draw on insight and support from other local professional leaders, including the LMC, area team and CCG.

A spokesperson for NHS England said: ‘Practices that are placed in special measures will have the option of joining the 12-month pilot that NHS England is running with the RCGP. They will contribute half of the costs (up to £5k) and NHS England the remaining half.’

NHS England went on to add that it expects the amount of practices placed in special measures to be low, and it is difficult to predict how many practices will apply for the support programme.

The spokesperson added: ‘At this stage it is difficult to say and will be dependent upon the number of practices being placed in special measures (which we expect to be low), the underlying issues and how easy these are to rectify, and whether they already have support in place to address these problems.’

But GPC deputy chair Dr Richard Vautrey said the move to charge practices up to £5,000 to access essential support could be the ‘final straw for struggling practices’.

He added: ‘There may be many reasons why a very small number of practices find themselves in special measures but many of the reasons may be out of their direct control and may be linked to the woeful under funding of general practice which is having an impact on the quality of care all practices are able to offer.

‘If a practice is struggling financially it would be a real blow to then have to find £5,000 to pay for a support package. This could be the final straw for a struggling practice and could mean the difference between staying open or closing altogether.’

It comes as the CQC officially launched its new inspection regime of specifically GP practices at the start at the start of the month, and the recent publication of its handbook on how practices will be given ‘Ofsted-style’ ratings

Practices will be given an Ofsted-style rating of either outstanding, good, needs improvement, inadequate for a total of 42 ratings which will have to be displayed in the practices and on the website alongside their final score.

Pulse recently revealed that the CQC will be able to access GP records without patient consent, while the regulator is also looking at the GP records of the most vulnerable children as part of an inspection programme of child safeguarding policies.

Readers' comments (11)

  • Every day I have these little mini-dreams, thoughts if you like about how pleasurable it would be to be "shut down" and never have to see the practice again. The final wave goodbye, the crocodile tears and the placing of old journals in a bin-liner. To be denied this perpetual "honour" of being a GP. This "honour" is clearly too great to be "bestowed" on undeserving GPs!! Let us all go and then get some "real dcotors" in place instead.

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  • Funny - I don't remember RCGP being active in supporting practices locally where as an LMC we have held practices hands from the start. We are also intensively supporting a number of practices following adverse CQC inspection reports. This is in partnership with NHS Eng Area Team and CCG.

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  • Hmm, nice bit of business income for the RCGP. So how firmly will the RCGP stand up for GPs against the CQC stasi?

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  • Yet again, an organisation acts like a black hole, sucking in resources, time and effort, growing ever massive, ever more -selfimportant, and delivering nothing of use. I will leave it up the reader to guess whether Im referring to the GMC, CQC, NHSEngland, RCGP, some, or all.

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  • Took Early Retirement

    At the risk of being flamed, I think a practice will have to be pretty bad to have sunk to the level of "special measures"- unless, of course, the goalposts move on what constitutes "bad" so that even not having hot espressos ready for the punters is considered bad practice in the future.

    So, if remedial work is needed, then unless there were unusual extenuating circumstances, I think a contribution from the practice would be in order. Might help with some people's motivation?

    However, on current trends the numbers would be very small.

    Flame away!

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  • I think you are right John, assuming that the bar is set at the correct level. Just had our inspection and await our report so may disagree with you later!!

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  • Yep that'll be the day. £5k I don't think so. One closed practice, 2000 patients sloshing around an almost broken system and a new locum is born.

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  • When I looked, out of interest, at the GP practice CQC inspection reports of practices with whom I worked a few years ago, I thought they appeared pretty accurate. If practices are finding that they are failing to meet the standards required, why don't they buddy up with a local one that does and find out what they're doing right? In my experience it's having the right systems and procedures in place and that staff know what to do for safeguarding, confidentiality issues etc.

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  • I was trained to seek evidence in deciding if an intervention made a difference. Can someone show me the evidence that the CQC - which must be sucking millions out of the practices inspects leads to tangible real outcomes in improvements in patient care? This is a pointless organisation that parasitises the health service. A whole inspection-regulation complex has developed feeding its own growth. It needs to be dramatically scaled back.

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  • kafka
    stalin are forgiven

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