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Council to ‘publicly hold to account’ practices with poor CQC ratings

GPs in one area of the country have been told they will be ‘held to account’ by the local council if they do not start getting good ratings from the CQC.

Announcing new measures, Thurrock Council in Essex said it wants all practices to get at least a ‘good’ rating from the CQC – and threatened to hold ‘poor performance to account, publicly’.

The council has ordered local public health and CCG officials to develop a scorecard to monitor practices’ performance, and is working with the local Healthwatch group to ‘raise the public’s expectations’ of their local GP surgery.

But GP leaders said councils have no authority over general practice and slammed local councillors for ‘rushing to stick the boot in’ on struggling practices.

The new measures, led by Conservative Party councillor James Halden, cabinet member for education and health, were ratified at a council meeting this month.

It comes after half of GP practices inspected by the CQC in Thurrock were rated as either ‘requires improvement’ or ‘inadequate’.

Cllr Halden said: ’We will never shrink form holding poor performance to account, publicly. This is an exciting new phase of ambition for primary care in Thurrock as we show system leadership and work to all providers being “good”.’

Cabinet board papers put forward by Cllr Halden explained how the council ‘will produce a scorecard based on local metrics to enable all partners to hold poor performance in primary care to account and act as a critical friend to drive improvements’. 

The scorecard – which will focus on long-term conditions management – is being developed by the local public health team in collaboration with NHS Thurrock CCG. The local Health and Wellbeing Board will use the data ‘to nurture peer support amongst GP practices whilst ensuring an effective partner challenge relationship amongst Board members’.

The council acknowledged that many factors including lack of GPs and practice staff back-up were likely contributing to variation in performance on long-term conditions, and that all but four practices ’have levels of under-doctoring that are worse than the England average’, with the worst-off practice having a patient-doctor ratio ’over five times the England average’.

Dr Brian Balmer, Essex GP and former GPC negotiator, said: ‘There’s nothing like giving GPs a good kicking when they are down. The CQC has gone through Essex like a horde of locusts to be quite honest and some practices are still recovering.

‘So the council deciding they are going to have a go is par for the course. But it doesn’t have any statutory duty and they will only be involved as much as CCGs and practices allow it – the council is not the regulator. Practices may want to co-operate with the council but if they start asking for things they are not entitled to, we will tell them.’

Dr Bob Morley, GPC lead on contracts and regulation, said it was ‘very disappointing’ that a local council was ‘sticking the boot in’ to underfunded practices that were already being more tightly regulated than ever before.

Dr Morley said: ‘General practice is on its knees after more than a decade of funding cuts and deliberately destructive policies and yet, despite being subject to greater than ever regulation and performance management from just about every conceivable angle we now have a local authority, in cahoots with a CCG and public health team that should both know better, rushing to stick the boot in.’

He added: ‘These people should be working with and supporting general practice and ensuring that it’s adequately funded, rather than enthusiastically joining the throng that are hammering nails into its coffin.’