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CQC rejects simplistic ratings for GPs

The CQC ratings system to be introduced by the new chief inspector of general practice will not follow the star ratings previously used for hospitals as it would do little to reflect the realities of general practice, their GPs has announced.

Professor Nigel Sparrow, the national professional adviser for primary care for the CQC, told delegates at the Family Doctor Association conference in Nottingham that its review into the ratings system would eschew any star ratings in favour of one that reflected a more ‘complex general practice’, but would be likely to use the same five domains and four levels as in the revised hospital ratings subject to consultation.

This move has been welcomed by GP leaders, who said the complexities of general practice ‘cannot be boiled down to one simple score’.

The ratings system – which will be implemented in April 2014 – has sparked concern among the profession, prompting FDA chair Dr Peter Swinyard to question whether CQC ratings are ‘for politicians or for patients’.

Professor Sparrow insisted that the CQC was thinking along the same lines as the profession. He said: ‘We don’t want a star rating to say you’re an expert and you’re a rocky practice.’

He added: ‘What we don’t want is a whole set of league tables which compares apples with pears. So the more complicated [CQC ratings] get, the more useful it will be and more difficult for politicians to point the finger.’

Dr Richard Vautrey, GPC deputy chair, said this was a welcome approach.

He said: ‘We have been concerned about the potential over simplicity of a single rating score for general practice. The single star rating was a failure when used for hospitals and we believe any such simplistic scoring for general practice would also fail to reflect the complexity of what we do.

‘We have had discussions with the CQC about this and it is good that Professor Sparrow is listening to us and recognises that the complexity of general practice cannot be boiled down to one simple score. We will continue to work with him and the CQC to try to create something that patients find helpful.’

In the run up to the consultation, which will be finalised this autumn, Professor Sparrow invited GPs and practice managers to involve themselves in the decision making. He told the conference: ‘We want GPs to engage with the methodology, to ensure it is professionally led.’

Professor Steve Field, who has been appointed as chief inspector of general practice, will implement the new ratings system.

This also follows comments by NHS England’s deputy medical director Dr Mike Bewick that suggested that comparative data on GP practices including access, referrals, immunisation rates and patient experience are being considered for publication by NHS England.

Professor Sparrow also revealed that the CQC will be satisfied with a ‘common sense’ approach to inspection, adding that inspectors were not expected to ban carpets, toys or report ‘how often something has been cleaned – what we want to know is that the doctor is aware of infection risk.’ 

He was questioned about an inspection where a GP was asked to produce a log book to show how often a stethoscope was cleaned. He replied: ‘I sent a memo out about that yesterday saying that must not happen.’

So far, 283 practices have been inspected, with the CQC aiming to have visited 20% of all practices next year. A practice is given a two day warning following a phone call, unless it is under ‘risk-based’ inspection, which usually follows a complaint from the local area team or CCG, and a visit will be unannounced.

Around 26% of practices inspected were not compliant with one or more standards. Professor Sparrow claims that figures may not be representative as the first practices who were targeted were those the CQC already had concerns about.

Please note that this story has been amended. The original version said that the CQC had rejected ‘Ofsted-style’ ratings for practices, but this was incorrect.