This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

CQC closed down 14 GP practices across England in the last year

The CQC forcibly deregistered at least 14 GP practices last year, the highest number to date under its three-year inspection regime.

The figures, revealed in board papers published this week, relate specifically to practices that had been placed in 'special measures' following an inspection identifying 'serious failures of care'. It comes as the CQC directly cancelled nine practice registrations in 2015/16 and 10 in 2014/15.

The papers reveal that around a third of practices in special measures ended up deregistered, either by force or voluntarily, while two-thirds improved enough to be taken out of the programme during 2016/17.

Pulse also understands that some practice registrations were immediately cancelled by the CQC upon inspection without going through the special measures process but the CQC did not provide a figure for how many practices it closed down in this manner. Therefore, the number of practices which were stripped of their registration in the last year could be higher.

In addition, the end-of-year figures for 2016/17 reveals that a further 37 practices voluntarily deregistered their contracts after an inspection or whilst being in special measures, but the CQC highlighted that this could be due to practice mergers as well as closure.

The latest report showed that out of 133 practices which left special measures last year, two-thirds were taken out of the regime because they made significant improvements and were no longer deemed inadequate. The remaining third were either closed down by the CQC or have themselves deregistered, and 130 GP practices remained in special measures on 31 March.

CQC chief inspector of general practice Professor Steve Field said he found the process 'enormously encouraging'.

He said: 'What’s enormously encouraging is that our inspections are driving improvement – 90% of practices that we have re-inspected have improved since last October. Through their hard work and dedication, practices are making positive changes to the care they deliver.

'However, we still see evidence of too much poor care. Since we began inspecting GP practices in October 2014 we have found over 200 practices to be inadequate.'

Professor Field said that 'while this is a minority, this still amounts to over half a million patients in England who were not receiving the basic standards of care that they should be able to expect from their GP practice'.

But he added that he was 'glad to say that we have increasingly found that most practices that are placed in special measures use the support that is on offer to meet those standards'.

GP leaders told Pulse that that while the profession does not tolerate unsafe care, the CQC’s regime was a ‘massive, expensive, destructive hammer’ to solve a problem that exisiting contractual levers can address.

GPC’s regulation lead Dr Robert Morley told Pulse while the ‘very tiny proportion portion of unacceptable practices must not be tolerated’ this regime was not the solution.

He said: ‘CQC is a massive, expensive and destructive hammer to crack a tiny a nut.’

‘If any practice’s position is truly irretrievable then commissioners have always had the levers to deal with the problem, so they question must be asked as to why they haven’t. The current regime of general practice regulation by CQC is both unfit for purpose and unnecessary.’

The news comes as a Pulse analysis, published earlier this month, revealed that the CQC's first completed round of GP practice inspections concluded with 90% rated 'good' or 'outstanding' - and with a price tag of over £100m. At the time, the CQC declined to provide figures for how many practices it had closed down.


CQC 'special measures' programme in 2016/17GP practices
Entrants 155
Remaining in special measures (at 31 March 2017) 130
Exits (of which:) 133
Sufficient improvements 89
Deregistered 30
Registration cancelled by CQC 14
Deregistered before formally entering special measures 7
Source: CQC  


What is the CQC process for deregistering a practice?

Practices placed in special measures are deemed to have shown long-term failures of care and lack of effective management and have been rated ‘inadequate’ by the CQC following inspection.

The process allows practices to access a 12-month turnaround support package, delivered by the RCGP, but they also face re-inspection after six months and if improvements are not made can have their registration cancelled, or conditions placed on their registration.

Practices can also opt to deregister, for example where they have been dealing with long-term recruitment or funding issues and feel they are unlikely to improve, a provider can also deregister as part of a merger.

Pulse reported in June last year that the CQC had immediately removed the registration of an Essex practice and sought a magistrate’s order to close it entirely.

On another occasion it sought a magistrates order to close a practice in special measures after two surprise inspections, however following a legal appeal by the practice it later admitted it had acted ‘prematurely’.

Readers' comments (12)


    Unsuitable or offensive? Report this comment

  • So once they've got rid of the truly rubbish ones who are they coming for next?

    Unsuitable or offensive? Report this comment

  • I think the CQC mission carries on...destroy...destroy....destroy..

    Unsuitable or offensive? Report this comment

  • I wouldn't mind so much if CQC and similar took a standards-based approach, as long as it was uniformly rolled out across the NHS. But it seems to me that draconian standards are applied to front-line staff, whereas hardly anyone seems to do anything to address those guilty of poor-quality leadership.
    One law for the front-line workers, and another for those in charge, perhaps? That's what it feels like - unless I've missed something.

    Unsuitable or offensive? Report this comment

  • I agree with Lateral think, we have a secondary care service locally this is dysfunctional at best and disgraceful or corrupt at worst,
    Currently there is a six and a half years wait for a TKR or THR in my patch and getting worse day by day, there is no minister of health (NI), the trusts are in massive financial debt, gp is collapsing, and yet the blame always seems to be that it is the rubbish gp's fault, I give up, I really do!

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    Once again , an institution/establishment cannot free itself from history as we always remember Cynthia Bower, Winterbourne View , Ash Court , Grant Thornton report etc.
    When Master Yoda took over , the temptation of going onto a heavy-handed over-regulation culture is enormous. The urge and anxiety to prove the worthiness of his establishment overshadowed any common sense. Like any desperate measure , it comes with the price of collateral damage. While the sound principle of 'check and balance ' on performances can always be exercised in a low profile , Master liked to create as many adversarial headlines as possible. He did that in the 'right' place (his own specialty called general practice) in the 'right' time (Agent Hunt given the mission to destroy general practice in current form ).
    This is a Chinese saying, ' To achieve a win in one battle ,ten thousand skeletons are left to rot .'(一仗功成萬骨枯)

    Unsuitable or offensive? Report this comment

  • National Hopeless Service

    And how many new practices commissioned. Probably a big fat zero.

    Unsuitable or offensive? Report this comment

  • Excellent post by LateralThink.

    Unsuitable or offensive? Report this comment

  • What upsets me is the double standards. They should have closed down most London Prison healthcare services. The standards in most local London prisons are orders of magnitude worse than any GP practice I have been to as a locum. I am not sure why CQC accepts the difficulties and excuses in prison and problems there, which are clearly not tolerated in General practice.

    Unsuitable or offensive? Report this comment

  • We need more people to run the show.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say