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Independents' Day

Standardised into submission

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Once upon a time, though not actually all that long ago, someone who really, really hated general practice decided to devise something really, really stupid that would really, really wind us up.

And that, for those of you perplexed, frustrated and dismayed from reading the BMA’s guidance on the process – and for those who haven’t yet had the pleasure – is how CQC registration was born.

I’ve come across plenty of bonkers bureaucracy in my time, but this takes the whole pack of Hobnobs.

It is the epitome of some officious twat with a clipboard, and no knowledge of general practice, ticking boxes and causing trouble.

Yes, I know it doesn’t only apply to GPs – dentists enjoyed the process so much they started drilling holes in their own skulls. It just feels like it does.

Here’s the guidance in numbers.

Forty-six pages. Sixteen ‘essential standards of quality and safety’. Fifteen ‘regulated activities that can trigger the need to register with the CQC’.

Thirty-two mentions of the word ‘compliant’. Twenty-seven ‘procedures’ or ‘protocols’. Eighteen ‘enforcements’. Eleven ‘prosecutions’. Three ‘suspensions’.

And 40,000 GPs vomiting noisily in a corner.

Basically, we’re going to spend an awfully long time demonstrating we’re excellent at documenting lots of policies and procedures, or we’ll get punched in the face, repeatedly.

And for kowtowing to this process – remember, possibly the most annoying thing that’s happened to us, ever – we’ll have to pay.

Yes. We. Will. Have. To. Pay. An as-yet undisclosed amount. Every year.

Not only have we been irritated by a bloke with a clipboard – and for some reason, in my mind’s eye, he’s almost certainly wearing a moustache, even if he’s a woman – we’ve been mugged by him, too.

And, of course, CQC registration is just the tip of the iceberg.

I was discussing with my partners recently why, these days, we so rarely innovate within our practice. The answer, as they pointed out, is obvious.

We’re paralysed by everything that is handed down from on high: thanks to NICE guidance, appraisal, revalidation and now the CQC, we no longer have time to think, the latitude to experiment, the energy to drive forward.

To remedy the perceived shortcomings of a tiny minority, we’re all stifled and standardised into submission.

And while we’re distracted into proving what a good job we’re doing, we are, of course, unable to do a good job – an irony lost only on those who devise these insane initiatives.

Well, BMA. Have you missed an open goal here? Thanks for the 46 pages of guidance. But maybe this was a time when we should probably have said ‘enough’ rather than ‘here’s how you do it’. Particularly given that we’ve been looking for ‘action’ to highlight our pension rage.

Boycotting the CQC process would have galvanised virtually the entire profession. We all know that, sooner or later, like all lunatic bureaucracy, it’ll be scrapped by some politician banging a ‘let’s slash red tape’ drum.

Why didn’t we pitch for the happy ending by forcing the issue now – to save time, and our souls from being destroyed?

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder