Practice overturns CQC rating despite its concerns being dismissed by chief inspector

Exclusive The CQC has apologised and re-rated a GP practice after admitting to errors during the inspection, after its original appeal was dismissed by the chief inspector of primary care, Professor Steve Field.

The regulator admitted that ‘due process’ had not been followed when issuing a rating of ‘needs improvement’ for the Bristol University Students’ Health Service in March, including elements of good and outstanding practice not being reflected in the final report.

It changed the rating to ‘good’ in the final inspection report.

However, this was after the practice received a letter from Professor Steve Field dismissing the practice’s concerns, saying he had been ‘assured’ that the original inspection and rating was fair.

The CQC said overturning of a decision only happened in ‘exceptional circumstances’.

But the practice’s lead GP, Dr Dominique Thompson, argued the positive outcome is ‘an important message for colleagues’ that they should be challenging what they see as unfair inspections.

Dr Thompson had complained that the CQC’s inspection had failed in ‘due care’ in both the preparation and assessment of the practice.

In a letter to the regulator in March, she highlighted what she saw as unfair elements of the inspection report, including inspectors:

• Asking a range of questions on elderly care despite being informed that the practice’s list consists entirely of university students.
• Dismissing out of hand ‘award-winning’ innovations in young people’s healthcare.
• Using a tone that was ‘at times patronising and inappropriate’.

The letter added that staff were left ‘demoralised and disappointed’ by the inspection report, and that Dr Thompson was left ‘personally speechless’ when inspectors suggested the practice had not sufficiently demonstrated it was ‘caring’ towards patients

Dr Thompson asked for a re-inspection, and added that poor CQC ratings ‘have the potential to make a substantial impact on the ability of a practice to retain and recruit new staff, and attract funding, and ultimately its capacity to remain in business’.

However, in a reply sent to Dr Thompson a month later, Professor Field said he had ‘been assured’ via interviews with the inspection team that it was ‘experienced’ in general practice inspection in ‘many different settings’ and that this concluded the investigation into the complaint ‘which has not been upheld’.

But following a mediation meeting requested via the LMC, the CQC lead inspector did re-visit the practice, acknowledged that the first inspection had been lacking and re-rated the practice as good in all areas but one.

Dr Thompson told Pulse: ‘I think it can be very intimidating taking on a national organisation but if you are strong in your conviction that this is an error and they haven’t done a competent inspection I would encourage people to take it on.’

Last week Dr Thompson, who said she ‘didn’t sleep for three months’ during the ordeal, received a letter of apology from CQC head of general practice in the south region, Garry Higgins.

Mr Higgins admitted ‘due process in line with CQC policy was not followed’ and that that ‘examples of both good and outstanding practice demonstrated during the inspection were not reflected within the [draft] inspection report’.

He added: ‘I would like to assure you that lessons have been learnt and actions taken [and] convey my apologies for any anxieties caused.’

A CQC spokesperson said: ‘The ratings for this practice were reviewed as part of the CQC quality assurance and factual accuracy checking process. This only happens in exceptional circumstances, where information has not been available or collected on the inspection.’

It comes as it recently emerged that the CQC is reorganising its inspections in a bid to build better relationships with GP practices, with a lead inspector set to be named in each CCG area who will carry out the majority of inspections.