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Independents' Day

Most GPs don’t know what bad practice can be like for patients, says Professor Steve Field

Most GPs do not understand what really bad practice can be like for patients, CQC chief inspector of general practice Steve Field has claimed

In an interview with the Independent, Professor Field said that ‘most GPs probably’ aren’t aware of the damning effect poor service can have on patients.

Professor Field also said that the most common problems the CQC has discovered during the pilots of the new inspection regime is practices having out-of-date emergency medication.

The interview came after Professor Field’s recent announcemnet that GP practices that are judged ‘inadequate’ in a number of areas by the new CQC inspections will be placed in ‘special measures’ and given six months to turn things around before having their registration removed.

Following criticism of the CQC’s focus on poor performance, Professor Field defended the regulator’s actions.

He told the Independent: ‘Most GPs probably don’t really know what really bad practice can be like for patients.

‘And if we have got very poor practice – even in small numbers that is not good for the profession as a whole.’

But the chair of the GPC’s contracts and regulation subcommittee, Dr Robert Morley, said Professor Field’s comments were a ‘damning generalisation.’

He added: ‘While the headlines say “doctors”, his own quoted words actually say “GPs”. I’d be interested to know whether the chief inspector has any evidence to back up what he says, which I’m afraid has inevitably gone down very badly with the profession.

‘While I appreciate he’s trying to make the point that it’s only a small minority of GPs responsible for “bad practice”, the reality is that all GPs see its effects, for example having to deal with the fallout of things going wrong in hospitals.’

Professor Field also provided information about the first rounds of the pilot inspections.

He said: ‘The biggest problems we’re finding is medicines management. We’re finding a lot of practices that have out of date drugs including emergency medications. Not having drugs is also a problem. If you take your child in for a vaccination you want to know it is being stored properly and know that you’re having the right vaccine.

‘But if your child collapses because they are allergic to something in the vaccine you’d like to know that the surgery has got adrenaline to resuscitate you quickly and not wait for an ambulance.

‘A lot of people had a go at me personally because they thought I was having a go at GPs – but actually if your vaccines are out of the temperature range they might not work. If that’s the case you’re affecting hundreds of children and many adults.’

As part of the previously flagged proposals, the CQC has said that where ‘aspects of service’ are deemed inadequate, practices will have six months to make improvements before being placed in special measures.

The special measures will allow the CQC and NHS England to oversee the practice and set out clear expectations for improvement. If there are no sufficient improvements within a further six months, the practice will have its registration removed, the regulator has said.

Readers' comments (12)

  • Took Early Retirement

    Most academic GPs don't understand what being a proper GP is about.
    As it happens, my former practice had a good system for keeping all our drugs in date, but I wonder does it REALLY matter if someone has some IV Furosemide that is 2 weeks after its use-by date?

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  • Yep agree - many GPs have not clue of the long-standing affects their poor practise can have on patients - when things go wrong - they are only interested in protecting their own backs (and egos). Dent, deny, defend. Evade and obfuscate - that has been my experience.

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  • This is offensive trolling rubbish. Most GPs are in fact patients themselves and as such, are fully aware of the limitations of the NHS. Accessing medical care is a complete nightmare for doctors due to various GMC rules and difficulties with confidentiality in our small world.

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  • Most people don't hate the CQC and its characters because they want to catch people who are storing their vaccines improperly - they are hated because of the nonsense policy fiddling and administrative rubbish they falsely rely on as a marker of good care.

    Other HCP at 10:17pm you sound like someone with a strange axe to grind. Sub-par GPs need to be found and removed (just like builders, teachers, lawyers and HCPs such as yourself) but this isn't the process to do it.

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  • Peter Swinyard

    When I was a trainee GP in 1984, very few injectables had expiry dates. I was told "If it's not cloudy, use it". I still have an undated vial of haloperidol from 1984 so it has not expired.....
    ...I rang the makers of Dimotane LA some years ago to ask of the shelf life as I had some old tablets for my own use. The scientist told me it was a stable compound and unlikely to degrade with age if stored properly. I asked how the expiry dates were set. He told me that this was not the job of the quality control department but was set by Marketing.
    In reality, many of the drugs we dispose of are not "expired" - they are past their expiry date. This is not the same thing and not a marker of "bad practice". Accept vaccines etc and some like GTN genuinely expire. But frusemide tablets? Aspirin?
    Need to find another birch rod to beat GPs with, I think.

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  • What patronising rubbish that we don't know what bad care can be like for patients. Most of us ARE patients and if anything I'm amazed at what primary care achieves with such little funding and so much interference.

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  • When will this man realise that we can all see through the crap he pontificates . He is simply empire building and it has nil to do with real patient care.
    Shame he has no opinions on the poor resourcing of primary care, lack of GPs with some facing closure and increased expectations- ie the real issues facing us as a profession

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  • Bob Hodges

    Strangley enough Steve, increasing proportions of my 12 hour days are spent dealing with the problems caused by poor care delivered in other parts of the over-swtretched NHS.

    I do not, and never have, had a conceptual block on the possibility that I could cause similar issues were it to be MY practice delivering 'poor care'.

    Unless you are being misquoted, I suggest a period of 'quiet reflection' might be in order. I very much doubt that you have any evidence to back up your claim, and I doubt that any such evidence could exist.

    The damage that POOR LEADERSHIP is doing to our profession is causing real harm to patients RIGHT NOW. As we struggle to retain experienced and valued GP colleagues, I suspect that 'Steve Field and his insight-free twighlight zone' is rapidly rising up the chart of reasons cited for early retirement/emmigration

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  • can everyone look at the feedback he has of his own practice from patients and comment. people in glass houses? the whole thing is pathetic and will contribute to the gradual destruction of general practice. Yet people ask why no one want to be a GP or take up partnership. With friends like Steve, who the hell needs enemies?

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