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At the heart of general practice since 1960

CQC were 'draconian' in closing down practice, tribunal hears

Exclusive The CQC’s decision to close down a practice was ‘draconian’, and their concerns did not ‘justify such serious measures’, a tribunal in London heard yesterday.

Dr Mujib ul Haq Khan launched an appeal against the regulator yesterday after his practice in Southfields, south west London, was found to have breached multiple regulations in January, leading to the immediate withdrawal of his practice registration.

This left 700 patients having to look for a new GP, the Care Standards Tribunal in south London heard.

This is the first legal action taken by a GP against the CQC, and GP leaders had said that any successful claim would be ‘absolutely enormous’, and could subsequently embolden other GPs to take action.

In the pleading document submitted before the hearing, Dr Khan’s lawyers claim he is ‘very well-liked and respected by his patients’ and that his patients had provided ‘favourable feedback on the service they have received.’

Dr Khan’s lawyer claimed that he had addressed concerns raised by the CQC in visits in June and August last year, and that breaches identified in January 2015 – which led to the closure – were different.

But CQC inspection manager Rebecca Gale told the hearing that there had been ‘no significant improvement’ by the time of the visit in January 2015 after the initial visits last year.

The CQC says that inspectors found serious breaches, including out-of-date drugs, an empty first aid box and inadequate supplies of oxygen because the cylinder had expired in 2008.

The CQC claimed that during the January 2015 inspection:

  • a locum doctor at the practice did not know where emergency medication was kept on site.
  • another locum treated two patients at the surgery without access to emergency drugs or Khan being present.
  • medication was kept in Dr Khan’s emergency bag, but the lock was broken and it could not be opened without a screwdriver.
  • a locum unaware about the procedure to raise issues about patient welfare or child protection.

Dr Khan denies these allegataions.

When asked why the CQC had closed the practice immediately, Mrs Gale answered: ‘He had failed to meet previous warning notices so we took the escalation to the next stage.  

‘We had to take into account the history of the provider who had failed to respond to the breaches of regulations over the year.’

She added that the ‘overall condition’ of the practice had deteriorated.   

Simon Fox, representing Dr Khan, insisted that the concerns raised in the final inspection were different from the 2014 visits.

Mr Fox argued that because the practice is ‘so small’ and had less than five employees there was no need for formal systems to deal with emergency incidents.  

‘If there’s a medical emergency you are going to go to the one doctor on site, it’s common sense,’ he added.  

‘This was a singlehanded GP with one practice manager and two part-time receptionists.’

Summing up, Mr Fox said: ‘We would understand the decision to suspend if the failures in January 2015 were the same as the year before.  

‘These are new failures and they are largely because of the change to the practice which required locums to be brought in.’

Mr Fox added: ‘They are not the kind of concerns that would justify such a serious measure, such a draconian measure as a suspension.’

Iain Macdonald, representing the CQC, told the hearing that the problems flagged in January were ‘the latest and most serious examples of continuing management failures’.  

He said: ‘What were found in January 2015 were new failings, as though that somehow makes it better.

‘What he (Dr Khan) says is wipe the slate clean from what happened in 2014 and go back to the start.  

‘But here there were outstanding warning notices so that option wasn’t open to the CQC.  

‘The situation points to an overall lack of managerial insight.’  

A ruling is expected in the next few days.

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Readers' comments (25)

  • Go Dr Khan. All GP's are behind you.

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  • I've worked as a locum and many sites even new private ones get these problems so why target Dr Khan? At the end of the day an emergency = 999. There are only a few emergencies dealt in general practice and you could always get medicine from the local chemist.

    In fact with policies like this - one could find faults in any practice and that's why the CQC was set up - simply to bully practices into submission.

    the reason why he is being targeted is likely to be a political drive to get rid of all small practices (the 'conrnershop') and it is my opinion that with a foreign sounding name the CQC feels that he will be viewed as a bad GP anyway as most people are prejudice and no one will care. Actually a lot of GPs are interested in this and I wish Dr Khan all the best and hope you win.

    Before the bleedin hearts start -

    1. a locum doctor at the practice did not know where emergency medication was kept on site.

    I've never had to know where emergency drugs were kept. As a locum if there was an emergency I would call 999 first then ask a staff member to get hold of the emergency drugs on my behalf.


    2. another locum treated two patients at the surgery without access to emergency drugs or Khan being present.

    Seriously? what is this about. What is the point of having a locum if you are also expected to be on site.

    3. medication was kept in Dr Khan’s emergency bag, but the lock was broken and it could not be opened without a screwdriver.

    So it could be accessed although inconvenient. I agree that this should be sorted but shutting a practice down?

    4. a locum unaware about the procedure to raise issues about patient welfare or child protection.

    why is this Dr Khan's problem - it's a training issue for that particular locum and if in doubt call social services and ask. I still don't know how to fill out that wretched referral form but I fax a letter instead.

    I think a lot of partners need to support Dr Khan - why? if they can shut a practice this easily it means they can shut any practice for any reason.

    sadly the bleed-in hearts are going to say 'naughty GP he should really have done this and that' but can you honestly say that your practice is perfect? I've never worked in a 'perfect practice' and never will as such a practice does not exist.

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  • If the concerns raised back in 2014 were addressed then CQC should have only issues new notice of improvement for concerns raised in 2015.

    I am CQC Consultant and I know the political myth behind this is that certain departments wants to get rid of Single Handed GP's and this is one Legal way of getting rid of them. (I am sure you all know who I am talking about).

    I am looking forward for the case outcome.

    please feel free to learn at glance the new inspection style.

    http://www.qmads.co.uk/cqc-summary.html

    Best Wishes

    QMADS.CO.UK

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  • agree with 10:01...all support dr khan for these reasons....

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  • Tariq you are using this site to advertise your services...

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  • 10.01 you summed up every thing i wanted to say.
    so much fuss about emergency medication. it may happen once in a while. , you start CPR and doctors carry vital drugs in bag any way. all staff know where emergency drugs are. delay of few seconds does not change out come. i wonder if there a was medic in cqc team??
    as you say perfect practice does not exist and you can fail any one you like. i support dr khan.

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  • CQC inspections are a farce. The inspectors focus on the wrong things, which in most cases have nothing to do with patient care

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  • Get rid of this political quango - it is nothing but a bully and does NOTHING to improve patient safety.

    And...we pay for the pleasure!

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  • On one side there is the GP, after five years of undergraduate medical training and five years of GP Training, having all his appraisals completed satisfactorily, are now facing CQC inspectors who are questioning about antibiotic prescribing, and about what they must have in the emergency bag.
    Locums appointed at a short notice may not know everything , inspire of an induction taken place, but the practice staff is always available to help whenever there is a need for that. Why so fuss about it

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  • locums rarely know where the emergency drugs are. were GPs and aws mentioned emergencies almost never happen other than the ocasional nebuliser. if one occurred then one of the permenant staff members should find them. of course we should all check their whereabouts on arrival but I know this rarely happens. why pick on him and why is what a locum doesnt know Mr Khans fault

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