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Small GP practices ‘less likely to be open and transparent’, claims CQC

The CQC has said that singlehanded GP practices are more likely to work in ‘professional isolation’, and fail to communicate and engage with staff.

The regulator’s annual State of Care report, an analysis of standards across the NHS, claimed its inspections to date suggested singlehanded practices risked segregation and the creation of ’an environment that is not open and transparent’.

The report, which focuses on the first year the regulator’s new inspection regime, also said that practices given lower ratings could improve by offering patients appointments outside normal working hours.

However, despite the vast majority of practices achieving a ‘good’ or ‘outstanding’ CQC rating, the regulator said that it remained concerned by the ‘very poor care’ it had discovered at some practices – branding some of it as ‘shocking’. 

The report highlighted that 85% of GP practices inspected under the new regime, from October 2014 to May 2015, were rated ’good’ or ‘outstanding’, while just 11% were ’inadequate’ and 4% had ’required improvement’.

The CQC said the main area where GP practices were found to be failing was within the ‘safety’ inspection criteria – concerning issues that show a general lack of systems and processes.

But the CQC has said that it acknowledges the constant pressure that GPs are under to effectively manage the rising demand on their services, citing the ageing population, financial constraints and recruitment as key challenges facing the profession.

The report states: ‘Single-handed practices are more likely to work in professional isolation, resulting in a lack of communication and engagement with staff and patients, and an environment that is not open and transparent.

’Over the last 10 years the number of single-handed GP practices has fallen dramatically. We are now seeing the benefits of larger practices and joined up models of working. These include offering appointments to patients outside normal working hours by taking shared responsibility for extended accessibility, and providing a wider range of services than most practices are able to deliver on their own.

’GP practices deliver a better quality of care when sharing learning and providing joined-up care through multi-professional networks.’

 

 

Readers' comments (25)

  • Was this said by the CQC or the SoS,interchangable political dogma from the government backed Quango.The NHS needs to be depolitized before it fails or too much damage will be done for it to provide a service.

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  • "concerning issues that show a general lack of systems and processes"

    And there you have it ladies and gentleman, the death of General Practice where systems have become more important than patients and process is more important than care.

    Single handed practices have always been good at providing continuity and personalised care but this is something the CQC cannot or will not measure.

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  • translation and solution is 'we need to get rid of them'

    this is what has been inferred by Nicholson, RCGP, NHSE, CQC etc

    in short the end of small independent autonomous practice - the very definition of General Practice and the promotion of large scale super surgeries / federations / vanguards where a few who own it will prosper and it will the right size for multinational buy outs. Those working for it will be just another cog in the wheel. The job has become a soulless tick boxing exercise already with locum being the last independent area (?for how long). GP Partners bottled it when they could have gone the way of dentists but it's too late. Youngsters don't bother with General Practice - it's over.

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  • translation and solution is 'we need to get rid of them'

    this is what has been inferred by Nicholson, RCGP, NHSE, CQC etc

    in short the end of small independent autonomous practice - the very definition of General Practice and the promotion of large scale super surgeries / federations / vanguards where a few who own it will prosper and it will the right size for multinational buy outs. Those working for it will be just another cog in the wheel. The job has become a soulless tick boxing exercise already with locum being the last independent area (?for how long). GP Partners bottled it when they could have gone the way of dentists but it's too late. Youngsters don't bother with General Practice - it's over.

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  • "....could improve by offering patients appointments outside normal working hours"...really? Regardless of whether or not patients want/need them? Is this "normal working hours" or the recently redefined doctors' "normal" working hours? Now trying to use CQC to impose extended hours.

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  • Odd - I thought small practices were generally high QOF achievers and achieved high patient satisfaction ratings. Could CQC be missing the point?

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  • United Health and their ex-boss Simon Stevens now Chf Exec of NHS, don't want to take over lots of small lists. So the government quangos are all aimed at amalgamating practices into one big unit per town, to make it cheaper and easier for UH to take over.

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  • United Health and their ex-boss Simon Stevens now Chf Exec of NHS, don't want to take over lots of small lists. So the government quangos are all aimed at amalgamating practices into one big unit per town, to make it cheaper and easier for UH to take over.

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  • System and processes are a resource demanding activity and while the existence of those is beneficial in large scale organisations, smaller operators would normally function better on a less formal level, which cannot be reasonably measured by inspection metrics and is in conflict with the procative risk management. Which is what CQC is referring to.

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  • System and processes are a resource demanding activity and while the existence of those is beneficial in large scale organisations, smaller operators would normally function better on a less formal level, which cannot be reasonably measured by inspection metrics and is in conflict with the procative risk management. Which is what CQC is referring to.

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