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Professor Field: Super-practices (like my own) should be able to self-monitor

The chief inspector of general practice has said that GP superpractices – including the one where he himself is a partner – could self-monitor and face fewer CQC inspections in future.

Professor Steve Field was facing the House of Commons Health Committee alongside GPC chair Dr Chaand Nagpaul and RCGP chair Dr Maureen Baker today, as part of the committee’s review into the state of general practice. 

He suggested that ‘superpractices’ are already monitoring the quality of their practices and therefore the CQC could work with these bigger organisations so that ‘the inspections can be done less frequently’.

Professor Field referred to the Lakeside superpractice in Corby, Northamptonshire, and the Modality Partnership in Birmingham as examples of practices that could take on self-assessment.

He later told MPs that he was a partner at the Modality Partnership, which describes itself as the ‘first superpractice’ in the country, when discussing different models of general practice.

The chief inspector reiterated comments made earlier in the week in which he claimed he was ‘ashamed’ of his profession.

The comments around superpractices came after Dr Nagpaul and Dr Baker had told MPs that the CQC inspection process was adding to GPs being stressed and overworked by being overly bureaucratic.

Dr Baker said: ‘Where there are poor practices it is entirely right that those practices are identified and addressed, but that shouldn’t mean that the bulk of the profession is burdened with a very heavy, bureaucratic, onerous process, with many areas that people do not feel are valid in terms of quality and safety.

‘There should be a way to identify unacceptable, poor practice which is much more focused and proportionate and doesn’t produce a burden for the vast majority of practices which are good and outstanding.’

Meanwhile, Dr Nagpaul said: ‘What I am saying is that we need to have a sensible approach which is much more locally focused, and in real time.’

Professor Field said: ‘The monitoring is really important and once we’ve been through the baseline of practices, if we can improve on the data, and if local CCGs co-commissioning would bring in better monitoring of their practices – or for example in the Corby, Lakeside vanguard, which is a large group of GP surgeries, or Modality in Birmingham, they monitor the quality of the practices – it then means that CQCs could work with the bigger, new organisations and the monitoring function becomes more important and the inspections can be done less frequently.’

At the hearing, MPs also questioned whether Professor Field thought that the CQC should have more powers to help practices improve.

Professor Field responded: ‘I’ve been asked that and offered the idea of whether we should be given that resource. There was £10m which has gone to NHS England which is a start, to give out to practices which are struggling.

‘There was a suggestion at one point that we should have that money and use it ourselves and I thought, personally, that our role is to encourage improvement and work with NHS England.’

At the same meeting, he said that GPs had to ‘sell’ the job better.

He said: ‘I think general practice is the best job in the world. It is an amazing role where the patient satisfaction is very, very high, the public esteem is high. You can get involved in education or research or medical politics.

’I think what we’re not doing at the moment is selling that job and working systematically from school through to make it a better place for the youngsters to come in. Part of that is about investment.’