Revealed: Hundreds of practices rated risky after CQC botched up patient experience data
Practices that scored well on the GP patient survey were penalised by the CQC’s ‘intelligent monitoring’ scheme because it got answers ‘the wrong way round’, despite the error having been previously flagged up during testing.
During the regulator’s annual accountability hearing in front of the health select committee yesterday, David Behan, the CQC’s chief executive, made the admission that the regulator had changed the wording of the question on the patient survey around ease of access, but had failed to change the answers accordingly, an error affecting 400 practices.
This resulted in practices that received good comments from patients being marked as high risk for that particular indicator, while practices receiving negative comments from patients were given positive ratings for the indicator.
The risk ratings were published on the regulator’s website last month, and were immediately criticised by GPs for rating practices on imperfect data without completing an inspection. The ratings were seized on by national and local media, with practices marked as ‘at risk of providing poor care’.
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The CQC has already been forced to apologise to 60 practices who were marked as risky following errors with the indicators, which were first flagged up by Pulse, and has been forced to overhaul five of the 38 measures it uses.
But Mr Behan’s comments are the first indication of the extent of the errors.
He told the committee that its testing of the scheme in July ‘did not flag up any issues’.
He added: ‘What happened in the stakeholder discussions in August is that the question – and this is the first indicator that got withdrawn, the question about ‘can you get an appointment with your GP – that question was originally asked in the negative: ie, “do you have a problem getting an appointment with your GP”.
‘That was flipped around in August, so it was asked as a positive question. The error that we made was that the data wasn’t changed at that time.’
Dr Sarah Wollaston, the former GP who is now chair of the committee, asked: ‘In other words, having changed the question, you didn’t match the change in the answer? It was a complete flip – so people with good access ended up with a bad score, and people with bad access ended up with a good score. Is that a fair way to summarise it?’
Mr Behan replied: ‘Yes. It was the wrong way round.’
Dr Wollaston said that this was a ‘pretty serious’ mistake, and Mr Behan agreed.
He added: ‘We sent that data as part of our face validation exercise to over 400 practices. That is 400 practices out of over 7,500. People came back to us and flagged those changes but we did not pick that up at that time.’
The RCGP and the BMA have called for the whole ratings system to be withdrawn.
Readers' comments (25)
Anonymous | Sessional/Locum GP17 Dec 2014 10:28am
There has been a catalogue of errors in the short time that CQC has been involved with GP Practices. Perhaps it's time for someone to take responsibility and do the honourable thing?
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Anonymous | GP Partner17 Dec 2014 10:42am
Fechiniijits
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Anonymous | GP Partner17 Dec 2014 11:02am
‘Yes. It was the wrong way round.’
They don;t seem to have any idea of the damage they can cause. No idea at all. What with local complaints procedures, Appraisal , Revalidation , GMC, Health Ombudsman , civil action , poor performance units within nhse outposts and unfair local reputation smearing we have quite enough jeopardies without this Alice in Wonderland meets Franz Kafka approach.
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Anonymous | Sessional/Locum GP17 Dec 2014 11:26am
"People came back to us and flagged those changes but we did not pick that up at that time."
How can you not pick it up when it has been flagged to you? What that actually means is:
"People came back to us and flagged those changes and we ignored it"
Take responsibility properly for goodness sake.
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Had had enough | GP Partner17 Dec 2014 11:28am
The issue here isn't necessarily about errors with data, although this is a fairly major mistake, it is that this data should never have been publicly available and published on the website. If the CQC are going to stratify practices in terms of risk to help them plan inspections then this is fine. The only information that should be published is the report following a formal inspection
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Anonymous | Private GP17 Dec 2014 11:40am
The changes in NHs have all been for the worse after Harold Shipman.The PCTs could not be trusted to look after patients in following Evidence based Medicine.and In imposing effective faulty untried IT Systems were implemented to be be removed in a year after axing the user salariedGPs who had no role in advocating such systems.Tghis drained Britains finances. The PCTs powers were recently taken up by by CQC and NHS did not change PCT's dangerous and uneneconomical non cosr effective measures.Are we heading for doom!
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Anonymous | Sessional/Locum GP17 Dec 2014 11:52am
"The PCTs powers were recently taken up by by CQC"
To a point...but equally CQC have reduced a raft of nonsense like checking for paper protocols etc that never really had to be done before in this manner. It's extra work and it makes little difference to quality of care.
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Anonymous | Sessional/Locum GP17 Dec 2014 11:53am
introduced a raft of nonsense, not reduced it that should be...
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Anonymous | Sessional/Locum GP17 Dec 2014 12:28pm
How many blunders does someone have to make before they resign?
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Anonymous | GP Partner17 Dec 2014 1:08pm
If I publicly acused a practice of being rubbish I would expect to be struck off. The danger in a patient not attending a doctor because their perception was that they were poor may have dire consequences for that patient.
CQC, monitor, revalidation appraisal, CCG, Health and social care boards, secondry care, PPG, the daily wail all expect us to be something we're not and are all having a nibble at us and blaming us for things outside our control and critisising providing the all you can eat buffet for 70 quid a year /pt- let us GPs be and let us be GPs. It's a joke a disgrace and noone really gives a ....- except staff and GP in primary care
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