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CQC bows to pressure and drops risk bandings for GP practices

The CQC has dropped its ‘intelligent monitoring’ risk bandings and apologised to GPs after admitting that its original use of language ‘wasn’t right’.

In an email to GPs, the CQC said it had ‘listened to the concerns of the GP profession’ and, as a result, it will no longer give practices a banding on 1 to 6 to signify their potential risk.

It will also change the language it uses so that it ‘does not imply a risk to patient safety’, but it will continue to produce intelligent monitoring reports.

The regulator will work with the GPC and the RCGP to develop a ‘better way of reviewing practice data in the future’, it said.

The CQC published its ‘intelligent monitoring’ data in November last year, which gave practices a banding of 1 (potentially risky) to 6 (no risk) based on QOF and patient survey data.

As a result, practices who had been given ratings of 1 or 2 found themselves splashed across local media, while national media ran headlines stating that one in six practices were considered a risk to patient safety.

However, errors were found in the data and the GPC and Pulse called for them to be withdrawn as they failed to adequately reflect how a practice was performing.

The regulator did later admit there had been errors, but said that these bandings were not meant to rate practices, and was simply supposed to inform what practices to prioritise for inspection.

However, now the CQC has now apologised in full for the whole publication of the data following the lobbying from the profession and has agreed to stop banding practices based on intelligent monitoring.

The email stated: ‘What we published wasn’t right regarding the use of language around risk, and on the analysis of variation between practices. We apologise. We also acknowledge that bandings have been perceived as judgements about the quality of care. That was not our intent but today we confirm we are removing them for GP Intelligent Monitoring nonetheless.’

Cover December 2014

How Pulse reported the risk ratings last year

However, it has said that it will continue to collect intelligent monitoring reports.

GPC deputy chair Dr Richard Vautrey said: ‘This is welcome news and comes as a result of us repeatedly making the case to them that the system was fundamentally flawed. They are dropping the banding and use of language such as “risk” when looking at variation in data, and have agreed to work with GPC and RCGP to develop a better way of reviewing practice data in the future.’

The RCGP has hailed the decision to abolish the current banding system for GP practices as a ‘victory for common sense’.

Dr Maureen Baker, chair of the RCGP, said: ‘This is a victory for common sense and GPs across England will be very relieved and reassured by this decision.

‘We are pleased that the CQC have acted on our concerns and agreed to abolish the banding system until a suitable alternative can be agreed by all relevant parties. CQC inspections were introduced to demonstrate that patients were receiving high quality care from their GP practice.

‘But anomalies in the banding systems resulted in confusing patients and shaking the confidence of hard-working GPs across the country, at a time when they are already trying to deliver excellent care in very difficult circumstances.’

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Readers' comments (27)

  • Great. But why wasn't this looked at properly before passing this information to the media and in the process ruining the reputation of many good practices and causing panic to patients.

    Rating for the CQC: Inadequate

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  • will they publish a CQC apology that we can put up in our waiting rooms?

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  • I think General practice is in such a crisis, the cqc with its approach is making things worse- it has contributed to a single handed practice in my area which will soon have to close down- we will have influx of patients which we will no be able to cope with and the cqc will come and visit us and then be able to say we are not safe, well lead etc.
    what non sense- the truth of the matter is that the cqc is the problem not the solution to improving care

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  • This is a sorry business and of course attracts no headlines. Damage done by the ironically named" Intelligent" monitoring and the expensive and ultimately futile inspection process, which results in a vast industry inflicting largely unscientific measures into a system that has no spare capacity.
    One of the "Intelligent" criteria involved asking psychotic pateients about alcohol and noting it somewhere.A moment's thought would cause any rational mind to question the value of such a process. To use it to formulate some global concept of patient risk must be a fine example of lunacy.

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  • Peter Swinyard

    It is one of the paradoxes of current NHS GP work that we pay our executioners. The bandings were unscientific and even relied on retired QOF indicators - which clearly we make less effort to achieve - and on QOF which is and remains voluntary.
    Unscientifically, therefore, I rate the CQC as BAND 1 on its risk to the livelihoods and emotional health of GPs and their staff.
    But I may withdraw that rating in due course....

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  • How can band 6 be 'no risk' anyway?

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  • Get off your high horse CQC and walk a mile in our shoes. You are looking for the cherry-on-top perfection when the cake is rotting in the gutter. Wake up and smell the coffee.

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  • I don't think much of this as an apology - and it isn't clear whether the "Intelligent Monitoring" will still be issued in the public domain for use by NHS Choices.
    What will happen when/if CQC starts using care.data for this purpose?

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  • Just too late.

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  • First they under estimated the GPs, they thought we are just the way daily mail describes us.
    then after visiting GP surgeries, they learnt we are doing a great job, and they are treating us differently now.

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