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CQC: GP practices ‘improve patient safety’ despite ‘increasingly stretched’ workforce

The overall safety of GP practices in England is improving, although there is a concern about the ‘stretched’ GP workforce going forward, the CQC has said.

Its annual State of Care report said that in the safety category, 93% of GP practices were rated as good at 31 July 2018 compared with 88% at the same time in 2017. 

Overall, across all inspection areas, 91% of GP surgeries were rated as good and 5% as outstanding, with 1% rated as inadequate and 4% as requires improvement.

But the CQC went on to express concern regarding the GP workforce going forward, linking this to the ‘national drive to provide seven-day services’.

It said: ‘While more than 40% of GP practices now provide access outside of their normal hours, the general practice workforce is increasingly stretched, and there was wide variation in the proportion of patients in local areas that were satisfied with the appointment times they were given, from 45% to 79%.’

It noted that ‘satisfaction with GP services among the general public in most of the UK has fallen to its lowest level for 35 years’, and that ‘across our reviews, older people told us it could be difficult to access their GP’.

It added: ‘Inadequate access to GPs can lead to people relying on emergency services or reaching the critical point where they cannot access suitable care in the community’.

The CQC noted that this comes as there was ‘a continuation of the trend towards part-time working by GPs, with the number of full-time equivalent (FTE) GPs continuing to fall’.

The news comes as a recent Pulse investigation revealed that around a quarter of evening and weekend appointments are being left unfilled, while patients have to wait weeks for consultations within core hours.

BMA GP Committee chair Dr Richard Vautrey said: ‘Whilst GPs have stepped up and delivered extended access services across the country, it isn’t necessarily what the majority of patients want, as they would rather be able to get an appointment with their practice during the day time rather than waiting to an evening or weekend.

‘Now that the extended access in place it’s important going forwards that local practices have control of this and can shape it in a flexible way that better meets the needs of local populations and also helps to better manage workload pressures.’

Other findings from the CQC’s report included:

  • Most re-inspected GP practices improved (30%) but 11% deteriorated. Reasons included staff ‘taking their eye off the ball’ in other areas when attempting to rectify the original issue.
  • The quality of the majority of urgent primary care services is good. These include walk-in and urgent care centres, NHS 111, and GP out-of- hours services.
  • Private online providers of GP services have improved following CQC re-inspection, via measures including limiting medicines prescribed and the type of conditions they manage in an online environment. CQC will begin to rate such providers starting next year.

Dr Vautrey said: ‘Once again, CQC have found that GP practices are delivering a high quality service, despite the huge workload pressures that CQC themselves have acknowledged, and better than other inspected areas of health and social care. 

‘This is down to the huge amount of work GPs and their practice staff put in to deliver the best care they can with the limited resources provided.’

The annual review comes as the CQC has been told its inspection regime requires improvement, with GP practices among those least likely to improve as a result of the regulator’s current approach.