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CQC using untrained GP inspectors to 'fill in gaps' on inspections

Exclusive GPs enlisted in the new CQC inspection regime are being sent on practice visits without receiving any formal training because the regulator is struggling to recruit enough GPs to attend every inspection, Pulse has learnt.

The regulator has admitted it has been having difficulties in recruiting GPs to sign up as inspectors, and has sent out emails to all GPs in an attempt to plug the gap, informing them they only need six months general practice experience before becoming an inspector.

Minutes of the CQC’s May board meeting also reveal that practices have had their inspections delayed because of the difficulties.

GP leaders have criticised the pilot inspections, saying the CQC is proceeding at ‘unseemly haste’ and that, considering the stringent requirements for GPs to register with the CQC, having untrained inspectors was ‘insulting’.

The problems have emerged just a month after the CQC rolled out its new inspection regime, which will lead to practices publishing a ‘matrix’ of 42 different ratings explaining the outcomes of their inspection in their practice waiting rooms.

Chief inspector Professor Steve Field said all inspection teams would include a GP, alongside practice managers, nurses and patient experts as part of the new regime.

However, the minutes highlight problems the regulator has had in recruiting GPs. They said: ‘In the early inspections there has been some difficulty in identifying a GP for every inspection. When this occurred the inspection date has been rearranged for when a GP is able to join the team, ensuring that the methodology is not compromised.’

They added: ‘We are also looking at how we would use locum GPs to fill in gaps at short notice.’

The CQC confirmed that locum GPs who were being used to fill gaps in the inspections were not receiving any formal training, and were instead sent a training pack, information on the methodology and a phone call.

A CQC spokesperson said: ‘When we have used locums they are provided with information on the methodology, a training pack and in advance of the visit there is telephone contact with the inspection manager.’

Dr Robert Morley, chair of the GPC’s contracts and regulation subcommittee and executive secretary of Birmingham LMC, told Pulse that the regulator had sent emails to GPs informing them they only need six months’ experience.

He added: ‘They’re obviously rushing to plug these gaps, the whole thing with the new inspection is it’s all been put in place with unseemly haste.’

‘But they’re starting to pilot the new regime, even while they’re still consulting on it, clearly they’re making it up as they go along.’

Dr Morley added: ‘I’ve also seen adverts for inspectors which state that any GP with six months [salaried] experience is suitable to be an inspector. The whole thing seems absolutely crazy.’

‘It contrasts remarkably with the unbelievable bureaucracy and hoops that GPs have to go through as new partners wanting to join a practice, where they have to send in their CV and show they’re fit and proper people, interviews. The whole thing is really verging on insulting for qualified GPs.’

Professor Field told Pulse that he was ‘not keen’ on using locums for inspections, and that they hoped to have a ‘bank’ of trained GPs in time for the full inspection launch in October.

He said: ‘Because we are only looking at a few CCGs at the moment some of the trained GP live a distance away from the practices that we need to inspect, which means despite the fact that we have enough GPs there have been a few occasion that at short notice we have had few gaps.’

He added: ‘Personally I am not very keen on using locums in future because we will have enough GPs on our bank available for use, also when we go live in in October we will have inspections across England and GP inspectors won’t have to travel far.’

‘We have only used a tiny number of locums and then only when we have needed to, we are evaluating this approach for future use and if the evaluation finds problems then it won’t be an approach that we will use in the future.’

This comes after Pulse revealed last month that CQC inspectors can even sit in on patient consultations – though the CQC say this is in extreme cases only.

Readers' comments (22)

  • Took Early Retirement

    Sad that so many GPs want to join the CQC-Stasi. I guess it is a consequence of falling incomes?

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  • Bob Hodges


    Finding enough to 'inspect' others might prove a challenge.

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  • There have been lots of adverts on network locum on a daily basis......not a few! £75 per hour.
    I did consider doing some myself ( ex partner 20 years and ex trainer). I thought that maybe I could inject some sense of proportion and influence them for the better in order to support the partners being inspected, but then I woke up.

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  • Any self respecting GP will boycott these inspections. Do not sell your soul to the devil.

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  • I suspect that the CQC would find itself not fit for purpose if it inspected itself.

    What would they say about practices not using properly trained staff?

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  • refuse to allow them access to info without providing proof of appropriate training/qualifications...

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  • 'only need six months general practice experience'


    I was an unbearable pure as the driven snow ideologist at 6m in. Everything perfect!

    Now I'm a burnt out cynic at 22 years. Just enough is good enough!

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  • All Hail Steve Field Witch Smeller pursuivant .

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  • Oh Dear....oh dear, oh dear, oh dear

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  • I have quite a lot of CQC experience with dentists. As a dentist myself, I helped to train CQC inspectors and actually attended on many inspections as an expert advisor. Unfortunately there have been many misinterpretations of Standards with CQC visits and now this is being duplicated with GPs. The CQC have decided not to use dentists in future; instead they will use a small group of inspectors who 'specialise' in dentists.
    During CQC inspections, I did occasionally sit in on consultations provided the patient didn't mind.
    I can understand why you are unhappy about inspections, however I think it is important to understand where the CQC are coming from in this. They are not givers of good advice. Neither can you 'boycott inspections'. They are only looking at whether you tick the boxes. So having a carpet in a clinical area is a no no for starters. I know there's no good evidence, but that won't cut any ice. A non clinical inspector probably won't recognise the accuracy or extent of your diagnosing skills. But it is quite easy to spot if you keep patients waiting a long time or generate complaints on NHS Choices.
    My advice to you, following inspection; is to challenge any points of factual accuracy and have a plan to fix the other things they picked up upon. You only have 10 working days to do this.
    It is my hope that the inspections will become more useful and better focussed. Unfortunately this seems to have stalled in the dentistry process and currently the CQC have very little 'dental intelligence'.
    I am writing a dissertation on 'Efficacy in CQC inspections' and would welcome comments from any Pulse readers to

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