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Independents' Day

Professor Clare Gerada's letter to the CQC on restarting GP inspections

Professor Clare Gerada 

Dear Dr Rosie Benneyworth, 

I am writing to ask you to reconsider your decision to restart GP CQC inspections and urge you, for the sake of the mental health of the GP workforce not to, and to delay by at least 12 more months.

As the medical director of Practitioner Health, I have, for some time, been raising concerns about the mental health of general practitioners, which even before Covid-19 was very poor. Going into the pandemic GPs were exhausted, burnt out, demoralised and depressed. The impact of Covid will only exacerbate these problems as is already evident by referrals to our service.

We are at the beginning of the first recovery phase from Covid-19. The NHS as a whole is faced with re-prioritising and rescheduling work and practices are now having to adjust to working in new ways. As you can appreciate this is very challenging and even now systems are not fully embedded and to inspect now seems unreasonable.

It will at least take one pressure off an already psychologically traumatised profession

Furthermore, practices with a diminished workforce capacity are dealing with enormous unmet need compounded by a backlog of reports, referrals, and work, suspended due to the pandemic. They are also preparing for an inevitable second spike. Medicines and chronic disease reviews will now be at least three months behind. Screening has stopped and is only re-starting on a limited basis.

Staff development, including internal and external appraisals, have not been possible and have been deferred. This is not an inclusive list but illustrates that putting GPs through the additional pressures of having to prepare for an inspection might tip some of them over the edge of despair, leading to resignations and early retirement as well as a surge in mental illness amongst them. It also distracts from the task in hand – patient care and returning services to some sort of normality for patients.

GPs and their teams now need to re-group, to mourn the loss of friends, family and colleagues and to have a period of reflection to help them digest what they have been through and in so doing be in a position to support their staff and patients. They do not need the added work, distraction and psychological burden of preparing for an inspection, no matter how limited.

I urge you to seriously consider my request as it will at least take one pressure off an already psychologically traumatised profession.

Professor Clare Gerada MBE is medical director for NHS Practitioner Health

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Readers' comments (22)

  • Absolutely spot on but will they listen? To not inspect will de facto admit that CQC is non essential and I don’t see them as the sort of turkeys that will vote for Christmas. I hope that I have misjudged them!

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  • Its a great letter. What a crying shame that it had to be written at all. The CQC are so far out of touch they are not fit for purpose.

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  • Well said Clare, I haven't always agreed with you but that was spot on.
    I am on my way out but I fear for the mental health of colleagues that I am leaving behind. It is not just us GPs that are on our knees, our staff are too and CQC places a huge psychological burden on them too; fear of letting us down and lacking the "professional armour" to face down the jumped up inquisitors that the CQC send to find evidence of heresy.

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  • Thank you Clare for your realistic approach.
    Recently, the issues of Post-Covid impact on GP practices including mental health of practice workforce, psunami of workload, huge patient demands and need for CQC inspection to be deferred for at least a year was highlighted in Pulse articles from Tri-PCN Alliance of Waltham Forest London -
    " Re-establishing General Practice services after Covid-19" and "Restoring GP services will cost practices £6,000 a week".

    Clearly, Professor Clare Gerada's letter to CQC primary care inspector supports the views of PCN Alliance.

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  • Clare Gerada pleads an important case with merit and value!
    CQC should heed the “unintended” consequences of this bureaucratic challenge at this difficult time!
    Resignation levels could easily increase for no real benefit!

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  • Hear Hear - thank you
    From your ears to CQC ears we can only hope

    The vast majority of practices are rated good or outstanding and can be deferred - it's generally a box ticking exercise anyway for most

    well said Clare Gerada

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  • Thank you.

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  • i stopped paying into rcgp pocket when they made jamie oliver - a chef for god's sake - a honorary fellow.

    perhaps i should rejoin if there's more of this to come from "the college" !

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  • Thanks for this but I fear even a voice as eminent and well informed as yours will fall on deaf ears - hopefully CQC will open their eyes to the reality and inspect wrt context. Having said that, should ANYONE who doesn’t need to enter a GP surgery be allowed in - what is the risk:benefit here on a Covid let alone mental health level?

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  • It is difficult to know precisely what CQC's annual budget is, £166m? £211? Other?
    Regardless, if Dr Benneyworth agrees to the proposed 12-month delay, and if the Treasury agrees to treat CQC inspectors as ‘furloughed workers’ in the Government's "Coronavirus Job Retention Scheme", then there may be a sympathetic response from the CQC (if they are happy to receive their reduced/full salaries and enjoy a year-long holiday).
    If, however, the government makes them redundant, our plea will be dismissed.
    Eventually, the CQC will seek a compromise, but I cannot see them shutting up shop for a year.

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