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At the heart of general practice since 1960

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.

Readers' comments (26)

  • "lessons have been learnt and actions taken"isnt this the same type of beurocratic bull that was spouted after stafford and countless other omnishambles happening during the near past,and still the cockups come.

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  • Why hasn't Field apologised?

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  • Quis custodiet ipsos custodes?

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  • How many more 'lessons have been learned' statements are CQC planning to publish? They seem to learn very little.

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  • What lessons has Field learned?

    CQC has to be the most vicious, nasty, self-centred organisation in modern Britain.

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  • Would Pulse please put in an FOI request to make CQC publish what lessons they have learned and what actions have been taken.

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  • Our practice demonstrated good practice across all CQC measurements, and there were no significant areas of concern.

    What did disappoint was that in several areas where the practice has been innovative, or gone above and beyond there was no recognition of this and very little praise if any, which turned the outcome into a demoralising one, even though we are rated 'Good'

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  • And still he doesn't resign. Dr Field: RESIGN.

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  • Need a FULLY independent body to regulate healthcare. Not more dysfunctional, politically controlled Mickey Mouse quangos to add to the farce that is the 'modern NHS'.

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  • Bravo Dr Thompson, for standing up and fighting for your convictions. I wish more of us took a stance when needed without giving way to fear and apprehension.

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  • My warmest congratulations to Dr Dominique Thompson for standing up to the bullies. He has succeeded where the RCGP, BMA and LMCs have failed us.

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  • Is any of the three possible-

    1. legal action against the CQC
    2. refer head of CQC to GMC
    3. Vote of no confidence in CQC

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  • Anonymous | 15 September 2015 11:15am

    I do agree- Good rating is so broad and there is no recognition for excellent core services- for example our surgery scored 95-97% in few parameters where the national and CCG average was 64 and 67%,but not even a small appreciation by CQC-though they stated this in their report

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  • Vinci Ho

    So Higgins played the good guy and Master Yoda , the bad guy ?
    Is it at least fair to refund the CQC fees to the practice?

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  • Bob Hodges

    Burn down the Disco!
    Hang the blessed DJ!
    Because the music he constantly plays
    Says nothing to me about my life.
    Hang the blessed DJ
    Hang the DJ!
    Hand the DJ!
    Hang the DJ!
    HANG THE DJ!

    (The Smiths)

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  • John Glasspool

    This comment has been removed by the moderator.

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  • John Glasspool

    Ps. In the very unlikely event that anyone is concerned the third term might be homophobic, I find on the net that it is a synonym for idiot.

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  • Well done.

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  • Vinci Ho

    A bit of history

    Abraham Lauritz Jonssøn Quisling (Norwegian: [ˈʋɪdkʉn ˈkʋɪʃlɪŋ] ( listen); 18 July 1887 – 24 October 1945) was a Norwegian military officer and politician.

    Quisling first came to international prominence as a close collaborator of Fridtjof Nansen, organizing humanitarian relief during the Russian famine of 1921 in Ukraine. He was posted as a Norwegian diplomat to the Soviet Union, and for some time also managed British diplomatic affairs there. He returned to Norway in 1929, and served as Minister of Defence in the governments of Peder Kolstad (1931–32) and Jens Hundseid (1932–33), representing the Farmers' Party. Although Quisling achieved some popularity after his attacks on the political left, his party failed to win any seats in the Storting and was little more than peripheral in 1940. On 9 April 1940, with the German invasion of Norway in progress, he attempted to seize power in the world's first radio-broadcast coup d'état, but failed after the Germans refused to support his government.

    From 1942 to 1945 he served as Minister-President, heading the Norwegian state administration jointly with the German civilian administrator Josef Terboven. His pro-Nazi puppet government, known as the Quisling regime, was dominated by ministers from Nasjonal Samling, the party he founded in 1933. The collaborationist government participated in Germany's Final Solution. Quisling was put on trial during the legal purge in Norway after World War II and found guilty of charges including embezzlement, murder and high treason. He was executed by firing squad at Akershus Fortress, Oslo, on 24 October 1945. The word quisling has since become a synonym for collaborationist, an allusion to the very poor light in which Quisling's actions were seen both at the time and after his death.

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  • If Field has any integrity, he would resign, after his abject failure to ensure regulatory transparency and fairness.

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  • But he would probably be promoted to Parliament for his ability to effectively disguise being "not fit for purpose".

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  • These guys seem to making money but really just an opinion and here one can ask why the chief needed further challenge

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  • A seat in the house of lords more likely - the dream of most of our "leaders," all firm believers of the Animal Farm's: "All animals are equal, but some more equal than others".
    As you can see from the number of anons, we are petrified of a vindictive Medical Establishment.

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  • You go girl!

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