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CQC's risk assessment of GP practices will 'demoralise an already shattered profession', says Burnham

Exclusive The CQC’s publication of GP practices’ pre-inspection risk assessments risks ‘demoralising an already shattered profession’, shadow health secretary Andy Burnham has told Pulse.

Mr Burnham said he supported the principle of more transparency, but said that the CQC should have consulted with the profession before publishing the data yesterday, which categorised one in six practices as being at risk of providing poor care, based on data from QOF scores and the patient survey.

However, the CQC has defended its publication of practices’ risk assessment, saying that people ‘shouldn’t jump to conclusions based on indicators’.

GP leaders have denounced the decision to measure on ‘simplistic’ indicators and said placing them in the public domain creates more ‘sticks to beat GPs with’ before they’ve even been through an inspection.

The assessments are being used to prioritise when practices are inspected, but they have also been published on the CQC website and practices considered risky will have a red flag against them on NHS Choices.

Speaking to Pulse at the Commissioning Live conference in Manchester, Mr Burnham strongly criticised the regulator’s decision to put these in the public domain as it did.

He said: ‘It should have been done with more support from the profession. I’m not opposing the principle of what has been done, it is the way it has been done.’

He added: ‘To put information out about services without alarming the public, I think you have to have real solid evidence which is worked through with the profession. And I think because parts of the profession have felt unable to support this it ends up confusing the public. It was meant to help the public, and they’ve gone about it in the wrong way.

‘I can understand why this has caused alarm amongst GPs and members of the public. I think that’s why I say it needed to be done after an agreed set of criteria, then a process of inspection that people had signed up to. It’s not going to help bring stability to the system if we’ve got patients leaving practices and going to other practices.

‘I’m not against the transparency, and I doubt the profession is either – but it important to get it right and the Government has gone off too early on this. The worry is that it could demoralise further an already shattered profession.’

Sue McMillan, deputy chief inspector of primary care, told delegates at the conference that the risk assessments are indicators, and the CQC ‘never said we will use it in any other way’.

But Ms McMillan said the information was not being used the way it should be.

She said: ‘I feel sometimes it is used wrongly. I don’t like people jumping to conclusions based on indicators – they are indicators, nothing more, and we have never said we will use it in any other way.’

However, Ms McMillan said that publishing data was part of the ‘culture’ of being open.

She said: ‘I also think it is in keeping with that culture of being open about the information we are using and how we are using it and personally I think that is the more important thing.

‘It is our duty as a regulator to be very open about the information we use. We have used the words intelligent monitoring for quite a long time, and we have been saying to practices and the public that we use nationally available data to do our intelligent monitoring.

‘There are risks in publishing it because people will use it wrongly, but I think it is important to be open.’

Readers' comments (29)

  • CQC really has screwed us royally on this issue.


    "Sue McMillan, deputy chief inspector of primary care, told delegates at the conference that the risk assessments are indicators, and the CQC ‘never said we will use it in any other way’."

    So why is it on the front page of the daily mail?
    Such lack of political foresight.

    Burnham is right, but its clear he's tryring to score easy political points.

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  • Daily Mail jumps to conclusions,no sh*t Sherlock
    The CQC is run by naive fools but the they probably take the lead from the top.My practice is level 6 but my CCG tells me I prescribe too many antibiotics and don't diagnose dementia,how does that work

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  • Burnham wants us all salaried on £70,000 a year another deluded fantasist,he had an open goal against the Tories on the NHS but kicked it over the bar.once a class warrior always a class warrior I suppose

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  • Dr David Barrett

    Good catch from Pulse Team, saw you nail him Joe as he came out the room, but it was an easy political opportunity for him.

    CQC lady's talk was called:
    "CQC inspections: Driving standards through ratings" - she was late starting as she lost her PowerPoint slides. No USB data.... I gave her a Band 1 before I even heard her speak.

    And she went out saying this.....
    "I never like ending on special measures" I kid you not!!

    Meanwhile in Leicester, The Press are cold-calling practices. LLR LMC just released this statement which might help if your a Band 1-2 and get press calls.

    "We have learnt today that the Leicester Mercury is going to publish a list of surgeries and their ratings from the CQC IM Data"

    We are concerned that there will be unnecessary worry for patients and carers caused by the premature publishing of data from an untested monitoring tool. We fully expect that practices labelled as ‘potential high risk’ will have this confounded by good and satisfactory inspections in most cases.
    The Intelligent Monitoring data is not without its inaccuracies and this is something that the CQC recognises and accepts. The CQC also accepts that the IM data provides nothing more than a snapshot insight into the practice and in for some of its measures is outdated by 18 months or so. It is important to stress that the risk score is no way reflective of the care being provided by the practice but rather a simplistic means for CQC to identify and generate its practice visit schedule. There may be very good a reason why a practice is deemed an outlier and this is not reflected in the risk score that is generated. Is it surprising that a University practice has lower than the national average of end of life care plans? It is important to be clear; this is not a judgement on the practice or the care that it is providing and it important that patients or any other body do not misconstrue it as such.
    The Local Medical Committee is working closely with the CQC, NHS England, the Clinical Commissioning Groups and the practices we represent to improve practices facilities and services.

    The LMC looks forward to supporting the CQC as it develops and improves its monitoring tool to ensure that in future there will be a fair and balanced view of primary care in the area.

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  • Vinci Ho

    Didn't see that coming so fast . AB obviously has a team( like the others)to monitor our responses and wasted no time to score some points.This matter is inevitably politicised . I see both advantages and disadvantages. At the end of the day, it is the public getting more and more confused about right or wrong.
    Master Yoda has really made a mess for his bosses , Agent H and Darth Vader. This poor deputy was only trying to patch up the surface of a rotten fruit. Again , she only served for her master.
    Expect Agent H ,NHSE , RCGP and GPC to release some statements soon.......

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  • It's 2119 hrs and I am sitting in front of an NHS computer to do some more work as I have finally put the children to bed (good dad). I have seen or spoken to a total of 64 patients today. I have done more the 50 scripts. I have 46 letters and 29 blood results to look at this evening. I still need to do my appraisal documents as it's due soon.

    I just had a look at the rating of my practice -BAND 1. This is even before they speak to any of my patients or seen any of my hardworking staff. Disgrace!! is my only word. . Do any of my patient have a choice. They are lucky if they are accepted in any other practice as we are all struggling with the workload.

    Prof Field. Thanks for uplifting my morale today. I am sorry i cannot do anymore than I am doing.

    My last promise, I will look at the bloods tonight in case I have to call the OOHs for some hyperkalaemia that the labs didn't bothered to call about as they may be feeling like i am feeling now. (s***t)

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  • 1984- good old george orwell

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  • Vinci Ho

    For those who loved 1984, please read the trilogy of The Hunger Games( especially CG if you want to know who Katniss Everdeen is)....,,

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  • Prof Fields & the CQC have brought the profession into public disrepute using inaccurate data inappropriately. This must be retracted immediately with a public apology made.
    Should disciplinary or legal action be taken?

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  • Vinci Ho

    Agent H just loves to use 'statistics' to rule , doesn't he? So look at your GP's statistics on CQC website and your surgeon's statistics on MyNHS.
    As Keogh said this morning , we are the first country to publish things like these to the public.
    What a great achievement , my comrades , in both primary and secondary care.........

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