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GPs go forth

Hunt to announce new 'rigorous' inspection regime for GP practices to improve patient care

Health secretary Jeremy Hunt will announce a new ‘rigorous’ inspection regime of GP practices this week, with the appointment of a new chief inspector of primary care to raise standards the Department of Health has revealed.

According to a briefing ahead of the speech, the DH said that Mr Hunt would announce a move away from the ‘box-ticking culture’ in the NHS and a return to the idea of the ‘family doctor’ so that patients know who is untimately responsible for their care.

He will say that one of the reasons for the recent pressure on A&E departments is because patients are going to A&E because there is no ‘credible alternative’. 

He will add that a new ‘rigorous’ system of inspection will be introduced to see the focus put firmly back on whether GP practices are providing effective and responsive care for all. A new chief inspector of general practice will be appointed to make sure this happens.

He will add that he wants a similar situation as in hospitals where a named doctor is responsible for the care provided at all times, and that they are clear the ‘buck’ stops with them.

Mr Hunt will say: ‘As a member of the public, I want to know my GP. And I want my GP to be someone that knows me and my family.

‘Yet we’ve turned GP practices into places where it’s a daily challenge for receptionists to cope with huge call volumes and GPs to get through to all the people they need to see.’

The Daily Mail also quotes the health secretary saying: ‘Everyone agrees that hospitals should only be a last resort for the frail elderly and that – for someone perhaps with dementia and other complex conditions – A&E departments can be extremely confusing places.

‘But what alternatives do we offer? GP surgeries where it is often impossible to get an appointment the next day; same day appointments but only if you call at 8 o’clock in the morning sharp and are lucky getting through; long waits on the phone to get through, sometimes at premium rates; difficulty in registering with another practice if you move home, or aren’t happy with the service you are receiving; out-of-hours services where you speak to a doctor who doesn’t know you from Adam and has no access to your medical record.’

It comes after Mr Hunt gave his clearest indication yet that he expects GPs to take back responsibility for running out-of-hours services.

Speaking on the BBC’s Politics Show yesterday, Mr Hunt said: ‘I think we need to go back to GPs having responsibility for making sure that for the people on their list there is a good service available.’

Deputy GPC chair Dr Richard Vautrey said he was waiting to hear details of how the new inspection regime would work.

He told Pulse: ‘It is essential that they will take a reasonable, pragmatic and proportionate approach to general practice inspections and regulation, understanding that we are not working in a sterilised operating theatre but a consultation room that mother’s regularly wheel prams in to.

‘In addition any attempt to introduce simplistic summary scores for general practice will not help inform patients about the quality of care we offer. We provide a complex service and this cannot be boiled down in to a simplistic and superficial judgement.’ Click here to read Dr Vautrey’s full comments.

RCGP chair Professor Clare Gerada said that the college supported any plans to promote better quality in general practice.

She said: ‘[We] are open to working with the Government and the CQC to devise a system that is going to create the right incentives to improve standards, including whether there is a case for introducing a chief inspector of primary care. But this must be done without adding to bureaucracy or creating a crude system of overall ratings for GP practices.’

‘Rumours of Ofsted-style inspections and tougher regulation are unhelpful and extremely demoralising, especially at a time when GPs are already heaving under the pressure of a bureaucratic and stifling tick box culture.’


Readers' comments (35)

  • If it happens - I'll loose 10-15% of my income, but balance it up by reducing the expenditure by letting go of my staff, including salaried doctor. The result will be less appointments for my patients.

    I'm afraid I'm not prepared to work even longer (50+hrs is enough for me) for less pay. If that makes me a lazy over paid GP, then so be it.

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    Maybe all is not lost?

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  • Nicholson has nothing to do with it.He is not the one unilaterally imposing contracts upon us:a mere puppet and a scapegoat

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  • Does anyone really know the real value of having "own notes"versus emergency care summary. Suspect it's not nearly as useful in preventing admission as has been stated.People get ill at nights and weekends when there is no other support for them around. Are the real problems not long term lack for support for A&E-you heard it understaffed, underfunded not appreciated-an ageing population and unfettered demand for free services? No wonder the system is failing. GPs working all night and weekends won't solve these problems. Look elsewhere.

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  • @Anonymous | 21 May 2013 5:59pm

    Its all rearranging the chairs on the Titanic

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  • @Hasan Habib 21 May 2013 2:35pm

    So you suggest laying off a salaried doctor to maintain your profit margin.I guess you must be sitting on your arse all day doing nothing.For those GP partners who have a full week that's not an option.How are we going to acommodate the extra clinical workload?

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  • Our organisations need to get tougher and mass resignation needs to be a serious option if things are worse and we are forced to do more for less!!!

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  • Returning 24h care to partnerships is a legal minefield that is probably too complex for the government to pull off. I doubt the government can simply shut down OOH companies without a prolonged and expensive fight through the courts. General practice is already pretty onerous so few GPs will be seeking to increase their hours and in this era they can't be forced to with modern EWD law and UK health and safety law banning driving without sleep. Remember you don't need to see much drop in GP numbers to cause primary care to collapse and there is already a looming recruitment crisis.

    Returning to co-ops will reduce salaried/partner GP availability in office hours and might make the whole situation worse as appointments in the productive time of day are reduced if locums are not available. Not only that, there are limited support services at 3am so shifting care to the early hours will reduce efficiency. Ultimately the government will wake up and realize they actually have a doctor shortage and they are unable to beat market forces forever. Salaries can only go one way from here...

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  • "Mr Hunt will say: ‘As a member of the public, I want to know my GP. And I want my GP to be someone that knows me and my family."
    I think that Mr Hunt has slipped into some kind of time warp, or possibly he wishes to undo the last 50 odd years of GP history, if he seriously thinks that it is realistic to have a GP who knows him and his family, who is available both during the day and at night. Even when I started in partnership over 19 years ago, about a year before the formation of the GP co-op in our area, there was no way I knew most of the patients who called OOH as the practice had about 18,000 patients. Also the notes were locked in the surgery (well, 3 different surgeries, actually). Consulting without the notes was a regular and frequent occurrence both in and out of hours.
    I resigned from partnership last year, worn down by 12 hour days and constant box ticking. I shed some tears when I found some old maternity form folders and realised that I could put faces to those names from about 15 years ago more easily than I could remember the patients I had seen the previous week, but I shed no tears for the loss of the old way of delivering OOH. In many respects it was dangerous for both patients and doctors.

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  • How will the Chief Inspector of GP Practices evaluate a surgery without a great deal of box-ticking?

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