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Independents' Day

‘This is a slur against a hard-working practice’

Dr Christopher North explains how he was blindsided by the CQC

We are a large training practice. We passed our most recent CQC inspection in February this year with no complaints. The report is available on the CQC’s website.

We also provided all the evidence that is required for the deanery training inspection, which is unbelievably extensive and probably more complicated in manyrespects than a CQC inspection because it is highly focused on clinical performance.

We passed that and the report said we provided excellent training, had good communication between the trainers and were a very well-run practice with a supportive learning environment. Our senior trainer was said to be ‘outstanding’.

We have had no concerns expressed to us by our CCG, with which we have a very close relationship.

Despite all this we have been publicly named by the CQC as presenting the highest level of risk for providing poor care, based on skewed responses from a tiny number of patients to an Ipsos MORI survey with a 40% response rate.

Unverified and unbalanced:

My major concern about this process is that it is unverified and unbalanced. They are taking information, putting it into an unbalanced and unverified rating process and drawing a conclusion.

I have no problem with the process of banding itself. I agree that the CQC has to try to prioritise its work somehow. But publishing it, in the way that they have, using words like ‘risk’, and ‘elevated risk’, has meant that people have interpreted it in a bizarre way.

I am very happy with the whole process of CQC inspections – they can inspect us as many times as they want. But we now have this slur put against
a hard-working practice. It reflects on my staff, my colleagues, and it is almost impossible to remove that slur without another inspection.

It is all very well to base inspections on this, but who gave them permission to put red flags against our NHS Choices information? What is that all about? NHS Choices is flawed anyway, but that is a disgrace.

This is way beyond what they should have done, beyond transparency. This is bullying, of people who can’t fight back.

Dr Christopher North is a GP at the Marlow Medical Group in Marlow, Buckinghamshire

Readers' comments (16)

  • "I am very happy with the whole process of CQC inspections – they can inspect us as many times as they want. But we now have this slur put against
    a hard-working practice."

    isn't this the sort of naivety that has got UK primary care into trouble.

    Undoubtedly this writer is a decent sort, but if you think any of the hurdles you are being made to jump through has anything to do with real assessment then you need to wake up.

    The only reason you have multiple versions of surveys and checks is to ensure you fail somewhere. To ensure whatever you do you will always be on the backfoot. Its been used in management circles for years - especially when trying to performance manage someone out of the door.

    You are under a full frontal assault

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  • Vinci Ho

    (1)The political mission started when CQC released the risk banding data. This had to be followed by some Agent H's subordinate(who obviously needs to know how to inflict trauma)to exploit these data ,twist the truth to condemn all GPs and threaten to wipe out all of us.
    (2) The message to us is 'stop moaning or face extinction , this is what you can get from government , take it or leave it.'
    (3) What do we call this , ladies and gentlemen ?
    (4) RULE BY FEAR. And one of the Four Freedoms identified by Franklin Roosevelt is exactly Freedom from fear, my comrades.
    (5) ''The Conservative Party has issued a voluntary code of conduct to all its MPs telling them not to "bully, abuse or harass" their employees.'' ''
    11/4/2014. BBC news

    I guess some habit is hard to rid as far as this party is concerned. Dr Sarah Wollaston, where are you these days?

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  • It is truly incredible that some of the best practices offering good care are showing the highest risk. This must show that it is wrong. I now see so many good doctors with years of experience retiring. Would Alan Suger do this to his best people?! Practice Managers are stressed all the time and becoming ill. What a great way to treat people!

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  • .....please don't be surprised - it started with Gordon Brown and continues unremittingly taking GP to a place that I honestly don't even think 'they' know or can visualise. Undoubtedly breaking up our contractor status and binding us to salaried contracts run by faceless box tickers measuring THEIR own outcomes "look aren't we doing well!"

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  • Would a law suit for defamation be any good. Perhaps BMA or RCGP would help bank roll a test case?

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  • You are the bison in the river & they are the Paleolithic hunters. Its no good bellowing as the flint spears pierce your hides. Turn and fight, as a mass trample them (all resign. Set up copayments cf Australia, or watch them destroy your species). Consultants are shamen fighting spiritual ghosts themselves in public, no real help. pickings for hunters....

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  • Zbigniew Myszka

    It appears the two assessment processes gone through in the practice involved seem at odds with each other. Does that mean that all the other practices are also misleadingly labelled or is there a further process needed to collate the contradictory findings in this unusual case. My feeling is that the thought given to the assessment is NOT of a joined up nature, immature and still in a development phase. As such, its findings should not have been published until the whole process is rational and nearer the truth than at present. That the majority of practices may be happy with the grading applied does not mean it is correct and universal. The fault needs to be identified and revealed to allay suspicion, mine at least, of both sides of the coin.

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  • Any practice would think of itself as hardworking and would consider themselves slighted should they get a negative report. This does not make the negative report inaccurate. However, from what the writer says, there does appear to be a mismatch between what is being said and what is being written (in the reports). From what has been said, it appears the writer was not informed of the public "naming & shaming" before it went public so they could at least formulate a response/action plan. One other view is that those practices providing care for the highest risk patients are the very ones where patients, by the very nature of their conditions, may be at risk from receiving poor care. Either way, it is not what you could call "positive re-enforcement"

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  • Having spent many years in professional market/social research, and served as a Regional Chair of the Market Research Society members organisation, it would appear to me (without having the details of the research structure and mechanics) that this Ipsos Mori "research" may well be invalid.

    A 40% response rate in itself can be valid but only IF it is based on sampling that is stochastically structured, correctly weighted, and the questions are clear and without bias.

    It is also extremely important for the patients surveyed to have been selected by the researching agency to be representative of the practice population, and NOT self-chosen by their deciding to respond to that survey. The latter case is well documented to not be representative, and therefore totally invalid for sound research purposes, and also especially not for use in public disclosure for monitoring purposes.

    I would strongly suggest that Dr. North demand the research methods details, challenge them as needed, and if verified as invalid, then demand that the red flags be removed immediately, and a public apology be provided on all relevant websites. Do COMPLAIN - the squeaky wheel gets the grease, and "if" this is an example of bad practice on the part of monitoring organisations, then it needs to be nipped in the bud, for Dr North's practice's sake, and for the profession.

    Don't be a doormat for the bureaucrats and politicians (of whatever party).

    Ipsos Mori will doubtless have connections at the Market Research Society, and would not want to be embarrassed by being linked with unsound research on one hand, and by a client's mis-use of research results, on the other: two very different issues that need to be independently verified. Don't let any perpetrators get away with bad practice; turn the spotlight on them. Best Wishes.

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  • Critical reflection mate!

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