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GPs to be interviewed to measure their compassion, says CQC lead

Exclusive: CQC inspectors will measure how caring and compassionate practices are by speaking to GPs, as well as staff and patients, to ‘get a sense of the practice’s values’ under plans being formulated by the regulator.

In an exclusive interview with Pulse, Professor Nigel Sparrow, national professional advisor for primary care for the CQC, revealed that the regulator was looking at ways of measuring practice values in an effort to make the inspection regime more ‘holistic’.

He also indicated that the frequency of the inspections would be risk-based, with practices where there has been safety concerns being inspected more frequently.

This follows health secretary Jeremy Hunt’s announcement last month, of a ‘rigorous’ new inspection regime of GP practices, which included a revamp of the way inspections were carried out and a new chief inspector of primary care.

The CQC began its inspections of practices just two months ago, with practices due to be inspected every two years by the regulator. But Professor Sparrow revealed that the regulator was already looking at how it can improve the inspection regime to take account of the ‘less easily measured aspects of general practice’.

Professor Sparrow said: ‘Currently we [the CQC] have lots of information sources, lots of metrics, but they don’t include the things to do with care, compassion and values. It goes back to the idea of holistic care.

‘We will look at this, but I think the only way to measure these things will be for inspectors to talk to people in the practice, that way they will get a sense of the practice’s values. We really want to find out: is the system well led, safe, caring, is it responsive to people’s needs?’

Professor Sparrow confirmed that this included speaking to GPs. He said: ‘When I used to visit practices for training practice accreditation, I used to spend a few minutes sitting in the waiting room and those few minutes were extraordinarily valuable.

‘They are not the things you can measure through numerics, but it gives you a general impression of the culture of that practice and how caring and compassionate those staff are, and I think it is important that we include that in our inspection regime.

‘When you discuss the way that the practice functions with a doctor, you get an idea of the culture and ethos of that practice and that builds into the dataset. So we look at data, we listen to patients and we talk to people.’

Pulse revealed last month that the CQC was planning to measure practices on five domains, including how caring they were for patients, and this is the first indication of how they may be applied.

Professor Sparrow also confirmed he anticipated a move towards practices deemed at high risk inspected more frequently than those deemed less risky to the public.

He said: ‘We haven’t decided on frequency, but I think it will be largely risk-based. Any practices that have declared non-compliance will be visited sooner rather than later, and those where safety concerns have been highlighted. So it will be about risk-based assessments. We don’t want to be visiting practices unnecessarily.’

He added he expected that each inspector would have a GP, practice nurse or practice manager present at all inspections to advise them. So far the CQC has appointed 65 GPs, practice nurses or practice managers to accompany inspectors, but it is looking to recruit ‘as many as possible’, he added.

A CQC spokesperson said that from July the CQC will begin a public consultation on the set of fundamental standards that all health and social care providers should meet and that next year there will also be a consultation specifically on how primary medical services should be inspected.

He confirmed it is likely that this will be led by the new chief inspector of primary care once they are in their role, but it will be informed by a stakeholder’s advisory group that includes GPC, RCGP and Family Doctors Association representatives. The CQC said they are still in the process of defining what the chief inspector of primary care’s role and remit will be.

Dr Mohammed Jiva, medical secretary at Rotherham and Bury LMC questioned how care and compassion would be measured, and said it would rely on individual inspectors’ perceptions.

He said: ‘The question I would ask; what tool will be used to measure compassion? Is it going to be patient feedback, carer feedback, professional feedback? It needs to be evidence-based and something that can be applied nationally.

‘Part of this relies on individual perception. The GP may be put in a difficult position because of local commissioning requirements. They GP can’t give the patients what they want due to commissioning restraints. The patient perceives they are not compassionate and understanding. The CQC will need to ensure that they understand that this is not the GP’s fault.’

Readers' comments (44)

  • Anon 8:38

    I can only assume you are not a GP, or if you are very inexperienced.

    Perhaps you would like to engage your brain a little. Compassion cannot be measured. It is not even defined. You cannot enforce a one fits all idea of compassion to a diverse society - which is why GP with local and individual knowledge of the patients are valuable.

    We are also providers of health care, not just clinicians. As NHS have limited resources, part of our duty is effective use of this - it means we will have to manage the conflict of interest between patient's desire and the cost effective medicine. You may appear to lack compassion if you decline to do a home visit for a patient who is capable of going out but thinks having to use a bus is too much of a hassle and taxi is too expensive (believe me, I gets few of this), yet if I started to be "compassionate" I'll only manage to see 10 patients in a day, rather than 40.

    I'm afraid it is people like you with such shallow thoughts who is fueling the politician to bend the NHS to suit their political needs, when it should be designed to improve the nation's health.

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  • You can measure compassion.Remember that scene from Clockwork Orange:you pin someone down forcing their eyelids open and paralyse their eye muscles.Then you make the subject watch violent images and see if they show delight or not.The great thing about this method is that coupled with aversive conditioning (ie:electric shocks) you can train compassion into the subject.So if the CQC adopts this method not only can it potentially detect but also cure us GPs of hypo-compassionism

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  • 12 hour days without meal or tea breaks, are not particularly conducive to compassion. What does the CQC recommend I do about that?

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  • Anon 08:38
    You really show your understanding of human nature-get in there Prof Sparrow, beat some compassion into the professionals who are measured assessed, validated and inspected to within an inch of their lives.
    In fact, we all signed up to care for people with compassion and dignity, but this is being extracted from the profession (like so many others) by insulting levels of scrutiny!
    "The beatings will continue until morale improves" as someone once said!
    And I have size 5 feet!!!

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  • So if we as a group are so beaten up and demoralised why are we encouraging more youngsters to go into general practice?

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  • Isn't this what corrupt governments in developing countries already do?

    "We will inspect you based on MY opinion. You'd better look after ME if you know what's good for you" seems to be the order of the government officials in such country.

    I suppose Prof Sparrow wish us to take a backward approach does he?

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  • AS a former clinical psychologist and currently practising gp I can assure you there is no psychometric test currently inuse to measure compassion that hashigh reliability and validity

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  • I want to know whether we're really short of money or not because it seems there is alot to throw about.We already have patient feedback questionnaires and now the state wishes to introduce this.How is this going to "improve" upon what already exists?

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  • Could BMJ learning quickly organize an online module in how to appear compassionate please.or could the CQC front man point us towards a role model.perhaps dr sparrow himself could be one.

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  • As women are deemed to be more compassionate than men and general practice is now predominantly female this is effectively a non issue.Keeps the likes of Prof Sparrow in his ivory tower but otherwise a complete waste of taxpayer's money

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