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Survey finds GPs have little confidence in CQC as practice challenges 'maggots' claims

Exclusive Almost three-quarters of GPs believe the CQC inspection process is not an effective way of identifying poorly performing practices, and a similiar number believe it is not a fair way of assessing practices’ quality, a Pulse survey conducted in the wake of the regulator’s report on GP inspections reveals.

A snapshot poll of some 286 GPs, conducted yesterday by Pulse and run in association with and featured on ITN’s News at Ten, found most have little confidence in the CQC process.

Some 74% of GPs polled by Pulse said they do not believe the CQC process as it stands is a fair way of assessing the quality of GP practices, while 70% said it was not an effective way of identifying poor performers. The GPC has said it would challenge the CQC’s portrayal of GP practices and negative media coverage, which 95% of GPs said had resulted in the majority of GPs being unfairly blamed for the failings of a small minority.

The findings come as some of the initial claims about practices singled out by the CQC for criticism appeared to unravel. One GP practice said to have had maggots in a treatment room said in a statement that treatment rooms and consulting areas had not been affected.

Figures obtained by Pulse also reveal that 365 practices were chosen for random spot-checks in the first 1,000 inspections – significantly more than the 20% first reported by the CQC.

The CQC told Pulse that just under 30% of those random checks found non-compliance, thereby countering claims that the high failure rate announced by the commission yesterday was attributable to the fact inspectors had targeted practices where concerns had been raised.

However, GP leaders said that the CQC’s definition of ‘non-compliance’ was often based on a small single factor and labelling practices non-compliant over minor issues was unfair.

Chief inspector of primary care Professor Steve Field yesterday announced that 34% of the 1,000 practices it inspected had failed one of the inspection standards, with 10 practices having very serious failings. The CQC’s report resulted in blanket media coverage decrying the poor state of general practice.

But GPs responded furiously to the claims. Two thirds (67%) of the GPs polled by Pulse said they had no confidence in Professor Field himself as chief inspector of general practice. Some 15% said they did have confidence in him while 18% selected ‘don’t know’.

Dr Beth McCarron-Nash, a GPC negotiator and a GP in Cornwall, wrote on the Pulse website that she was ‘livid’ at the way the findings had been presented.

‘I am sick and tired of hearing this rubbish, and from a former professor of our royal college I would have expected better. I am extremely disappointed, because the tone of the press release in my view was not appropriate. It was disproportionate and it was inflammatory.’

She said that the GPC negotiating team was ‘not impressed’ and would be challenging the CQC.

Dr Peter Holden, a fellow GPC negotiator and a GP in Matlock, Derbyshire, said GPs ‘need to talk to Steve Field as this is getting silly’.

Dr Clare Gerada, who like Professor Field, is a former chair of the RCGP, told Pulse: ‘I think we are in the mindset of a moral panic about the NHS and GPs are being used as scapegoats. The leaders of the profession have to come to grips with this before we lose GPs. We, including Professor Steve Field, need to start protecting what we value most.’

Dr Gerada said that many practices were failing on minor factors that did not warrant the practice being labelled as non-compliant.

She added: ‘The CQC policy of naming and shaming is not helpful and out of kilter with the desire to instil kindness and compassion back into the NHS.’

Dr Gerada’s comments come as one of the practices that was named and shamed in the media as having maggots in a treatment room denied that this was the case.

A statement posted by the Dale Surgery in Nottingham on its website said: ‘We took immediate action to deal with a small number of insect larvae found in the hallway by the back door of our premises. These were not in consulting rooms or treatment areas. We contacted a pest control company to confirm that there was no evidence of wider infestation, which they did. It was the pest control inspector’s opinion  that the maggots had come from the public alleyway which runs along the back of our premises.’

Professor Steve Field told Pulse: ‘I have been clear in all my radio and TV interviews today that the majority of GPs in England are providing good care. Unfortunately there a small number of practices which are not compliant with essential standards as laid down by the CQC.’

‘The tiny numbers of very poor practices are letting down their patients and also the profession but we are pleased that there is significant progress being made by most of the practices that have been identified to address these deficiencies. It is unfortunate and I guess inevitable that the press have focused on those small numbers.’

‘Our new model that we will be bringing in next year will look at and celebrated good and outstanding practices and we have already begun to work with the GPs to make sure they are the forefront of our new approach to inspection. We want all patients to be assured and to know that they have good general practice whoever they are and wherever they live in England.’

Readers' comments (22)

  • Field likes his own soundbites. To his credit he's had the nouse to get away from the insanity of micromanged hell formerly known as General Practice. If his intention as a government apparatchik is to further dispirit a totally demoralised profession he's doing a fine job

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  • This comment has been edited by the moderator.

  • Inspections made against idealistic targets!
    What we are managing to deliver for the cost is unrivelled across the world and envied. HMG are putting us in a race to the bottom!
    I'm going to get a Rolls-Royce Phantom inspection sheet and apply it to a second hand Citroen C1 whose owner has tried to care for it but has 100k on the clock and is stuggling up hills but is still doing the job albeit in non Roller fashion..

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  • Reading the daily media crap about General Practice published almost daily starts off amusing then frustrating then enraging me.
    Can there be any doubt that Jeremy Hunt and pals are aiming to demoralise and undermine GPs and the NHS ?

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  • Stop defending the indefensible.

    Whether the maggots had crawled in from the alleyway, or off the diabetic foot ulcer, it is quite clear they have no business in the hallway of a GP surgery. No-one would tolerate it at home, let alone in a healthcare setting. And the practice had to have this pointed out to them by the CQC before they called in pest control...

    The other practices were administering out-of date-vaccines and mixing up medicines. Come on guys!! This is clearly unacceptable. It is quite reasonable to root out the very few bad apples that were found.

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  • It's impossible to give out of date vaccines as you have to record the date and batch number in the notes when you give the vaccine
    Again the lack of logic is ridiculous

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  • Vinci Ho

    (1) A game of statistics . 1000 practices have been inspected but majority is targeted, hence CQC has some prior information of concern . The final result of 30% practices 'non compliant ' cannot be extended to a conclusion that 30% of ALL practices had something wrong. Does the media and public understand that? NO. Do they love the headlines. YES
    (2) one practice out of 1000 (0.001%) had maggots not 30% had maggots. Of course , that is inexcusable. But does the public really get this? NO
    (3) Recent history of CQC has put it in a desperate position to do something to redeem its reputation . But fellow GPs , do you feel like you have been betrayed and sold out in this saga?
    (4) CQC needs to hold an official Press Conference to clarify all these above . As I said yesterday , CQC has the responsibility to ensure the correct information goes out in the public .
    (5) My practice had the inspection in October and we are certified compliant in all categories . (I stick up the copy of the report in our waiting room today )I hope my practice was not one of the targeted ones!!

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  • Dear Vinci,
    From your posts on pulse I am certain it was!
    Accept my congratulations that the system did not trip you up,

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  • Vinci Ho

    Life is short , mate.
    There are many things a lot more important . Fear is not one of them..........

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  • Vinci Ho

    Chinese say,
    'I dare not go to hell but who will then?'

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  • We've been CQC'd and cannot for the life of me think of a reason as to why we would have been referred. Passed without comment, pass training assessments on a regular basis and are a Goldilocks practice in all areas- ie not to hot or cold. We also don't take c'#p from previous PCTs and the CCG or patients. A spade is a spade. (perhaps that's it!)

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