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CQC forewarned over 'inevitable' media furore as GPC plans fightback

Exclusive The CQC were warned in advance that its plan to publish GP ‘risk ratings’ would lead to headlines denouncing the profession and would inevitably be seen as way of ranking practices, Pulse can reveal.

The GPC said they contacted the CQC on Friday, as soon as they found out about the CQC’s intention to publish practices’ risk scores, to warn the regulator that publishing the ratings was a ‘bad idea’ and would be used by the press to unfairly rate practices.

GPC leaders have also said they will be contacting the CQC to express the anger felt by GPs, and has already taken legal advice, which stated that there were no grounds for legal action.

The CQC has said that the rankings are not ‘judgements’ of practices, which can only come from inspection, and it ‘cannot control’ the subsequent coverage from the release of its intelligent monitoring data on Monday, which was published alongside a map which shows which risk-band each practice falls into.

But chair of the GPC’s contracts and regulation subcommittee Dr Robert Morley said the GPC had immediately contacted the inspection body to say publishing the ratings would ‘compound’ the problems from using the 38 disputed indicators, which are based on data from QOF and the GP Patient Survey.

Dr Morley said the outcome was ‘clearly obvious, entirely predictable, and inevitable’ and argued the data should have remained an internal tool for prioritising inspections.

He said: ‘GPC spoke to CQC on Friday after emails were sent to practices saying the rankings would be published on the CQC’s website, and they were advised that it was a bad idea.

‘I mean it is clearly obvious, entirely predictable and inevitable that once this came into the public domain that by some people in particular, certain elements of the press, this would be seen to rate practices – just as we have seen in the headlines .’

He added: ‘Why publish something like this when it is bleeding obvious that the press is going to have a field day with it?’

‘The CQC had previously been told by GPC that we didn’t feel that most of these indicators were fit for purpose but they still went ahead and used all of these and then compounded the crime by publicising them.’

The regulator’s report on Monday allows patients to access their practice’s scorecard, which gives a breakdown of any indicators where the practice is deemed to be at risk or elevated risk.

It is based on 38 indicators, which include clinical standards, such as coronary heart disease and dementia diagnoses, measured from QOF performance and also scores from the GP Patient Survey, including patient’s ability to access their preferred GP.

The report found that 80% of the ranked practices – which exclude those with incomplete data, such as Somerset where practices stopped the national QOF this year – are currently deemed to be of ‘low risk’.

But many practices deemed to be at risk have found themselves plastered over the pages of their local papers and contacted by patients, based on factors beyond their control.

GPC deputy chair Dr Richard Vautrey told Pulse GPs should be proactive in combatting negative stories in the local media, adding that the committee had already sought legal advice around the CQC’s actions.

He said: ‘We have taken legal advice and there is no grounds for legal action against CQC on what they did in releasing information as they did.

‘We are writing directly to CQC about this and wider concerns that GPs continue to raise about CQC and have spoken directly to senior members of CQC about the anger GPs have about this. It is important that local GPs respond to adverse articles in the local press to put the facts straight. We are already working with local GPs to facilitate this but that should not stop as many others as possible to respond too.’

A CQC spokesperson told Pulse: ‘May I suggest that you refer to what we have actually published rather than the subsequent coverage that we cannot control?’

And added:  ‘At all times, we have been clear that the intelligent monitoring bandings are not CQC’s judgments of services – these only happen once we have carried out inspections The intelligence packs are used for discussion with general practices during our inspections. The bandings are not judgements.’

‘We have not said that the evidence proves surgeries are putting patients at risk but as an independent, open and transparent organisation, it is our duty to be honest and clear about what our analysis of the evidence suggests and how we will use it.’

The intelligent monitoring data will be available through the new MyNHS section of the NHS Choices website, and Jeremy Hunt said the tool would be central to allowing patients to compare GP services through ‘Trip Advisor-style’ ratings.

Readers' comments (18)

  • If GPC want to be proactive then ballot members for industrial action or consider alternative contract models - listen to your members, you represent us

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  • The doctors involved in the CQC are partly responsible for this debacle, and may be breaching GMC guidance in terms of working with colleagues. What they have allowed here may be no less damaging for the professional as a whole than the article by Prof Thomas in The Daily Mail a few days ago.

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  • Vinci Ho

    ‘At all times, we have been clear that the intelligent monitoring bandings are not CQC’s judgments of services – these only happen once we have carried out inspections The intelligence packs are used for discussion with general practices during our inspections. The bandings are not judgements.’
    ‘We have not said that the evidence proves surgeries are putting patients at risk but as an independent, open and transparent organisation, it is our duty to be honest and clear about what our analysis of the evidence suggests and how we will use it.’

    (1)So CQC's judgements of services are far more important than the judegements of the public , people , our patients?
    (2)Education of the public is part of the responsibility of CQC and it is to explain properly in details how it is using these data to reach endpoints.That is the ultimate transparency, not the way you described.
    Misled education is the modern version of Ignorance, one of the five Giant Evils William Beveridge identified over 60 years ago on the foundation of NHS.
    In this case , confusion is created by CQC as it is twisting the true meaning of transparency with sheer ignorance.
    (3)Professor, you owe the public an open press conference to explain properly the ins and outs of this mess.

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  • Vinci Ho

    So this Sky sports analysts said,
    '' Andy Murray is having 30% first serve in,65% second serve in , five double faults, 35 unforced errors in this match so far,''
    ' What does that mean ? Do you think he is going to lose this match?'
    '' I don't know. He is at risk. ''
    What does that mean? He is going to lose , isn't he?'
    ''I didn't say that, it is your judgement ,''

    Such a wonderful gentleman..,,,,.,
    ............

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  • GPC TIME TO FILE A DEFAMATION ACTION. YOU CANT JUST KEEP TALKING - do something to protect your members for a change

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  • Some of the data used in the ranking have been outed by some practices to be incorrect.

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  • This comment has been moderated.

  • John Glasspool

    Anon 7.01.
    ANYONE can report Prof Field to the GMC. I have. (see other thread) Why don't you? The more, the better.

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  • John Glasspool

    IANAL but defamation is a very difficult legal area in England. I doubt it would get anywhere and would be expensive for BMA members; subs.

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  • Vinci Ho

    John , please don't mind me paste your previous comment

    John Glasspool | Other GP | 19 November 2014 8:15pm
    @ 10.10 am

    I have: this is the essence of my complaint:-

    In his role in the CQC Prof Field was responsible for massively misleading information about GP practices being given to the public, via the media, with no preparatory explanation.
    His behaviour contravenes your code of behaviour in the following ways:

    "You must work collaboratively with colleagues, respecting their skills and contributions.

    You must treat colleagues fairly and with respect.

    You must be aware of how your behaviour may influence others within and outside the team.

    Be honest and open and act with integrity.
    Never discriminate unfairly against patients or colleagues.

    Never abuse your patients' trust in you or the public's trust in the profession.

    You must work in partnership with patients, sharing with them the information they will need to make decisions about their care

    You must give patients the information they want or need to know in a way they can understand."

    Now, I am aware that you do not usually give the faintest care about doctors' feelings but you do presumably care about the stress and anxiety that will have been caused to patients by these inaccurately prepared findings. Many are now anxious about the competence of their practice. Some may be changing practice even now.

    I am aware that you took action against Prof Meadow, for allegedly not using his position as an expert correctly, with regard to his use of statistics, so feel this is a similar case.

    Complaint Ref E1-H5RPPI

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  • Vinci Ho

    There is a point far out there when the structure fail you , when the rules aren't weapon anymore.
    They are shackles letting the bad guys get ahead.
    Jim Gordon
    Dark Knight rises

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