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At the heart of general practice since 1960

I was inspected twice and I still can't fathom the point of the CQC

Inspectors looked through desk drawers when we weren’t looking

From Dr Siraj Shah, Gravesend, Kent

Our first CQC inspection (carried out with just 48 hours’ notice) took place last November during the busiest season for the profession, and amid extensive redevelopment works at our practice. The CQC inspector responded to my suggestion to postpone the visit by warning that I would be liable for a huge fine because I had not informed the CQC about the building works. 

The inspection itself was like a criminal investigation. The inspector frequently rubbed her fingers on desk surfaces looking for dust, despite witnessing the huge scale of ongoing building works. The disruption caused by the works, and the fact we had just 48 hours’ notice, meant we were not able to produce the patient survey report, recruitment or whistleblowing policies in time for the inspection – although none of these would have affected patient care at the time. 

Despite all that, I was relieved to read in the draft inspection report that there were no shortcomings in our provision of care, or in the welfare of the people who use our services. 

In my detailed response to the report, I sent the CQC all the missing policies and reports, and promised the two recommended actions (a lockable cupboard for scripts and a finalised recruitment policy) would be undertaken by 21 February. I also promised that the cleaning, infection control and legionella risk policies would be completed once the building was finished in August 2014 (they couldn’t be done any sooner). 

I have never received any acknowledgement or feedback from the CQC. This shows that inspectors have not taken on board the new approach that commission has widely advertised. Had they taken notice of my detailed response, there would have been no need for them to re-inspect the practice in September. 

Nit-picking

Our second inspection took place while I was away on holiday. I am glad to say we have now ticked all the boxes – but having studied a 19-page draft inspection report and received feedback from staff, I am concerned about inaccuracies in the reporting and the inspectors’ nit-picking approach. 

I was informed that during our second inspection, my partner had to go out of the consulting room to fetch some paperwork. Staff left in the room reported that the inspecting doctor on the CQC team grabbed the opportunity to sift through his desk drawers.

The second report, dated October 2014, said inspectors ‘found there was not an appropriate system in place to ensure staff learned from significant events. We saw records relating to significant event and accident recording and found no entries had been made since 2008’. 

This is strange, since one of the main strengths of our practice is learning from significant events, as born out in my own revalidation appraisal in March 2014. Between January 2013 and March 2014 we have recorded, discussed and shared learning from nine significant events at the practice.   

The long-winded, repetitive reports show that inspectors lack fundamental understanding and knowledge of GPs’ work, give more importance to a certificate or a policy rather than the service being delivered, misrepresent recommendations as requirements and, most pertinently, fail in their duty to provide accurate feedback about inspections to practices. So why do we have to pay a fee to an organisation that is not fit for purpose?  

Having seen my practice undergo two inspections within 11 months, and meeting all the CQC’s requirements, I utterly fail to understand the purpose of these inspections. 

GPs, struggling to deliver patient care given the recruitment crisis, also face overwhelming bureaucracy, political interference, fragmentation of care, lack of funding, unnecessary monitoring and micromanagement of practices. No wonder growing numbers of experienced GPs are taking early retirement, and the younger generation of doctors do not wish to take up general practice.  

CQC response 

A spokesperson for the CQC said: ‘Under the new approach, experts from the GP sector join each Care Quality Commission inspection. These doctors play an integral part of the assessment of GP practices and will contribute towards the future ratings system.’

 

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Readers' comments (7)

  • The CQC exists entirely for its own benefit. As regards the behaviour of CQC inspectors, ask yourslef what sort of busybodying failure who wants the opportunity to feel superior applies for CQC jobs?

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  • We should refuse to do any home visit where the dwelling has not been CQC inspected . That should put a stop to this travesty .

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  • the modern day stasi

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  • Extensive building work going on, not advised to the CQC. Was there a proper risk assessment for the work in order that the practice maintained staff and patient safety during that period? Notification of relevant authorities should be part of that process, so what else was missing. I guess the building dust you refer to only penetrated to non-clinical areas.
    Why didn't the practice share the evidence of the SEA to the CQC, if it was so well embedded. I suspect you protest too much.
    If they were checking drawers in your absence, that was poor practice. But you had nothing to hide, so it was surely only lack of good manners. Primary care delivers good, safe, effective care but has a stroppy culture of refusing to be tested on this. The world has moved on now. People want proof rather than aspirational statements and patrician assurances from the medical profession.

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  • Busy body failure oh dear I feel a practice manager doesn't like to be challenged here. As professionals we are all open to challenge its just GPs have never been used to it. Well get used to it as CQC appear to have enough busy body failures to thrive and actually have legislation on their side. Maybe feeling superior is not on their agenda just good quality consistent patient care that follows policy and process. After all this actually protects the GP and staff alongside the patients not the CQC inspector. Maybe its time we stopped bickering, worked together and got on with this. Its been happening in adult social care and the private hospitals for years without much agro, get used to it its here to stay.

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  • Siraj Shah

    If you had any knowledge or understanding about compliance with mandatory requirements like health & safety, risk assessment, fire and building regulations before and during any major building works can be undertaken in this country you would not have made such ill-informed comments. The answer to your other comments like SEA shearing and presence of dust during extensive building works without any background information about inaccurate CQC inspection report reflects a degree of naivety. If you wish to make any further comments in this climate of transparency please give a face to your anonymous comments.

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  • Would be fantastic if CQC staff were fully trained and up-to-date with policy and proceedure, as sadly lacking in all areas of healthcare appropriate training is required for all levels of staff, yes some doctors need training as do some nurses and HCA's, reception, managers, as do some CQC staff! enough said!

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