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The waiting game

CQC, take your own intelligent advice


So, let me get this straight. The CQC’s latest report states that, in the year to 31 July 2019, nearly a fifth of practices previously rated ‘good’ have slipped to either ‘requires improvement’ or ‘inadequate’.

But it has acknowledged that workforce challenges and rising patient demand have been significant contributors in this decline.

Which is brilliant news. Because the obvious conclusion to draw from this is that the CQC is simply setting unrealistic standards.

Given the unsustainable pressure on GP services, it should be accepted that the best we can aspire to is a barely safe mediocrity (NICE could take note of this, too, particularly with regard to the letter ‘E’).

I believe there may be one bullet left

So I look forward to the CQC’s new grading system which will presumably (and I admit I’m working from memory here) shift practices from ‘utter shite’ to ‘really quite remarkable given the circumstances’.

What the CQC is effectively admitting is that really it’s unfair and pointless to send the troops into battle with no ammunition, and then shoot them for underperforming.

So, CQC, given that your ‘intelligent monitoring’ was entirely responsible for the most massive and unjust blow to staff morale in my practice that I’ve witnessed in over 30 years at the coalface, and that your organisation itself is one of those workforce challenges you cite, can I suggest that you do the intelligent, and honourable, thing? I believe there may be one bullet left.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at or follow him on Twitter @doccopperfield

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Readers' comments (14)

  • Your shirley knot suggesting that the CQC has missed its own proximal target and shot itself in the foot?

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  • Unfortunately the only future viable career pathway in General Practice is not in General practice, but those non patient facing jobs that tell the rest of us how to do our working in CQC, RCGP, NHSE, PCN management etc so now we are split into those doing the job thats needed, who get stuffed over, and those who have moved into management who from their comments over the years seem quite detached from reality, but dont have to worry financially as they are knee deep in prawn sandwiches and hence dont even need to spend any money on lunch......

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  • This whole business is really really simple. No one should be allowed to comment on another clinician's work unless they have at least 20 years full-time experience in a reasonably well functioning practice.

    Loafing around an academic department or plonking your way through RCGP meetings does NOT count as full time experience at the coalface of primary care.

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  • Midlands Doc - they also need to still be at the coalface for 5 sessions a week minimum.

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  • You know that's not going to happen, Cops. Its a state bureaucracy, i.e. it is funded by the state and comes from the top. Only the top can get rid of it or even force it to change. How can we influence that? We stop voting for the status quo, for big government, and go for the TRUE libertarians, not the fake tories/labour-lite.

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  • Where's Optimus?

    Just hand all work to babylon gp at hand
    oh yes I forgot they do not want the difficult patients..
    How about practices say they are also only going to keep the easy patients only.. fit young mobile patients only ..
    can see the cqc rating going to ecxcellent very quickly

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  • Where's Optimus?


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  • Where's Optimus?

    CQC Should get practices to document how many doctors and nurses are available on a day to day basis
    some places are stretched so thin that often there's is only a single nurse practitioner struggling through..
    oh well .. this new brexit deal
    should help ... not

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  • Where's Optimus?

    Hey CQC
    What about failures in secondary care
    See articles on failing accident and emergency departments..
    Secondary care failures lead to disgruntled frustrated patients
    and lead to further demand and stresses on the failsafe nett that is general practice

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  • The only option in the current climate is for the CQC to lower its standards, what they rate shite now would become "outstanding" in the future- its called the genreral theory of relativity.

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