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CQC overhauls risk rating indicators as GPC declares scheme a ‘shambles’



The CQC has overhauled a number of indicators used in its risk ratings scheme, which GPC has said demonstrates the continuing ‘shambles’ of the intelligent monitoring initiative.

The regulator has announced on its website that it is changing indicators relating to the GP Patient Survey meaning that 60 practices given a initial risk rating of 1 or 2 will now be declared to be not a potential risk, and will be informed on Monday.

However, seven practices will also be given a higher risk rating as a result of the changes.

It comes after a huge backlash from the profession after the CQC published the ratings on almost all practices in England, based on QOF data and the GP Patient Survey, which was picked up by national and local media.

Pulse reported there were concerns over the accuracy of much of the data, including for those practices that had dropped elements of QOF and for the indicators relating to the patient survey.

The CQC said it was reviewing the indicators with the Department of Health and the GPC, and as a result it has revised five of the indicators.

The indicators that have been reviewed are:

  • The proportion of respondents to the GP patient survey who stated that the last time they wanted to see or speak to a GP or nurse from their GP surgery they were able to get an appointment;
  • The number of emergency admissions for 19 ambulatory care sensitive conditions per 1,000 population;
  • Ratio of reported versus expected prevalence for COPD;
  • The ratio of expected to reported prevalence of coronary heart disease;
  • Dementia diagnosis rate adjusted by the number of patients in residential care homes.

Professor Nigel Sparrow, senior national GP advisor and responsible officer, said: ‘Following feedback from national and local stakeholders, and working with NHS England, we have now completed a comprehensive review of the data and, as a result, there are a number of changes.

‘The vast majority of GP practices will not be affected by these changes. Overall, 60 practices (less than 1%) previously in higher priority bands 1 and 2 will now move to bands which are of lower priority for inspection. We will contact each of those practices to apologise for any concern this may have caused GPs, their staff and their patients. We will also contact the seven practices which will move into a higher priority band as a result of these changes. Updated IM reports and more information will be available on our website from Monday.’

He added that the CQC wanted to ‘reinforce the message that the banding is not a judgement’. Professor Sparrow said: ‘Intelligent monitoring will never be used in isolation to make a final judgement or produce a rating of a GP practice.’

However, Dr Richard Vautrey, GPC deputy chair, said this was another part of the ‘shambles’ that is the CQC’s intelligent monitoring scheme.

He told Pulse: ‘The reality is that this is a shambles and the CQC should have listened to us before releasing the first set of information. We called for it not to be published in advance and they ignored that.

‘They have agreed to work with us on developing a new system but it seems crazy to be tinkering around with something that is fundamentally flawed and has seriously damaged the reputation of many good practices and good GPs.

He added: ‘They should be withdrawing this flawed banding system.’