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GPs go forth

CQC could use information for intelligent monitoring

Exclusive The CQC could use anonymised patient data, extracted from GP records through NHS England’s initiative, to enhance its intelligent monitoring and inspection schemes, Pulse understands.

The regulator told Pulse that it ‘hopes’ that NHS England’s plans to expand the potential uses of to include ‘health intelligence’ would enable them to gather more information to be used for its intelligent monitoring scheme.

It has said that there were no confirmed plans in place, but it would have discussions with other parties about potentially using the new data.

GP leaders have warned that this use of information has ‘sinister undertones’

The CQC’s intelligent monitoring service currently uses data from the GP patient survey and QOF scores to give practices a ‘risk rating’ to prioritise potentially ‘risky’ practices for full inspections.

However, it came under heavy criticism from the whole profession for making these risk ratings public, despite being based on weak data, with GPs pointing out that there were problems with the patient survey and that QOF was an optional scheme.

But the CQC has told Pulse that it is looking to expand the data it uses, and could be a way of doing this.

A spokesperson told Pulse: ‘We would hope that in future, any national and anonymised analysis of could provide useful information to enrich our intelligent monitoring of services and feed into our inspection processes.

‘However, there are no confirmed plans for how CQC could use information extracted from to support our regulatory functions. Any changes would involve discussions with our partners, including NHS England, the BMA, and the RCGP.’

The Independent Advisory Group, which oversees, approved plans by NHS England in September to allow information to be used for the purposes of ‘research and health intelligence (which would include public health and regulatory functions)’ during the pilot stage.

A spokesperson for the HSCIC, which is responsible for the IAG, told Pulse that during the pilot stage ‘access is limited to approved analysts within CQC, Public Health England, NHS England and HSCIC’.

Dr Robert Morley, chair of the GPC contracts and regulations subcommittee, told Pulse: ‘It’s yet another very worrying development, not just in respect of yet another secondary use for with sinister undertones, but the fact that CQC is seeking to use it as part of their already discredited and unfit for the purpose of its intelligent monitoring process, as well as for rating practices.

The way the CQC has used available data for intelligent monitoring hitherto has been an absolute shambles and with its track record in this area I can’t see anyone being confident that this will now be used appropriately or add anything to the inspection regime

However, we welcomed the CQC’s commitment to discussing the matter with the GPC.

The scheme is intended to link patient information in GP records with hospital data to increase knowledge about local health for commissioning purposes, but has itself has come under criticism after it was halted last year, days before its scheduled national roll out.

Last September, the GP Extraction Service Independent Advisory Group (GPES IAG) – which Pulse recently reported would be abolished from June 2015 - allowed NHS England to allow to be used for regulatory purposes.

A spokesperson for the GMC told Pulse: ‘We don’t currently have any plans to use, however we will continue to look at the wide range of data available to us and how it might help to build a better picture of what is occurring in medical practice.

‘Our priority is to protect patients and we recognise the importance of using and sharing data from a range of sources to help us to do this.’

Pilots in four ‘pathfinder’ areas have begun enlisting GP participation, and Pulse revealed this month that NHS England hopes to notify patients in the majority of areas, about the scheme and their right to opt-out before the general election.

Readers' comments (10)

  • Vinci Ho

    Are we surprised?
    The pro-establishment coup share information amongst themselves .

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  • Took Early Retirement

    CQC is not capable of doing anything involving the word "intelligence".

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  • George Murgatroyd

    Surely is one of the few datasets that could usefully be used to compare and benchmark nationally performance at individual GP and surgery level? It is currently nigh on impossible to understand in a meaningful way if patients are receiving better quality of care at one practice than another. Any metrics developed of course need to be developed in collaboration with clinicians.

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  • Weather it is useful or not - is a secondary issue.

    The primary issue is that the CQC could not get the information accurately for the very simplest bits of publicly available information for the first round of intelligent monitoring. How can it be expected to analyse swathes of more complex information and make an appropriate assessment of a GP practice.

    For example - those patients most engaged in their health care are most likely to opt out of
    A practice taking a more proactive approach to consenting individuals (which surely is good care) will have more of the engaged patients excluded from the data - thus making the practice look worse.

    I would imagine it is much harder for the GP surgery to check the accuracy of information.

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  • This comment has been moderated

  • Hi I agree but fear that they ll do it anyway.potentially flaws info in the hands of someone that doesn't understand it fully would be a nightmare

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  • Are there really any more sticks to beat us with? Yes, so it seems. *sigh*

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  • With respect the CQC methodology is not discredited, the flaws in a small number of indicators were exaggerated by Pulse's biased reporting.

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  • All the CQC will be able to establish from this will actually be the degree to which practices choose to code information within patients' records. But will CQC have the 'intelligence' to realise this.....?

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  • Whether or not willfully, the IAG recommendations have been misquoted or misunderstood by the CQC spokesperson.
    The full recommendations throughout the various versions and amendments are at:-
    and the response of the Care Data Programme to the recomendations are at:- (or ) in the 12th February 2015 minutes.
    The minutes have information about the end of the IAG and the serious concerns expressed by the IAG about the planned replacement of its functions.
    The Lessons Learned document might be of interest - even though the lessons might seem to have been totally ignored.

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  • Just code everything 'had a chat to patient ' or if more serious 'discussion' and free text the rest

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