The CQC is set be given powers to de-register practices who fail to stay open at times convenient to the needs of the local patients under new proposals it is developing alongside the Government.
Under the proposals for a new set of ‘expected standards’ – to replace the ‘essential standards’ that practices are currently being inspected on, though many of the current essential standards will be incorporated into the new expected standards – the regulator gave the example of surgeries being ‘open at times to suit the needs of local patients’.
It also proposed that failing GPs can be prosecuted without issuing a warning note if they fail to meet new ‘fundamental standards of care’, the content of which they are currently consulting on.
The regulator said ts was highly unlikely to close practices that are not open at convenient times but GP leaders said it was not up to the CQC to police when surgeries are open and that the regulator should be working with GPs and not looking for ways to threaten practices.
As part of its ‘A New Start’ consultation, the CQC called for ideas on what should be included in a new set of fundamental standards, the minimum standards that all providers of health and social care will be required to meet.
The CQC suggested the standards should include things such as ‘I will be protected from harm during my care and treatment’ and ‘if I complain about my care, I will be listened to and not victimised as a result’. It said that anyone should be able to recognise a breach of these fundamentals of care, even in the absence of specific guidance.
The report said: ‘Fundamental standards of care will set a clear bar below which standards of care should not fall. These will focus on the very basics of care that matter to people and will be easily understood by all. There will be immediate, serious consequences for services where care falls below these levels, including possible prosecution.’
It added: ‘It is our intention that the new regulations will allow CQC to prosecute breaches of fundamentals of care without the need to issue a warning notice first.’ A CQC spokesperson clarified that the registered manager of the primary care medical service would be prosecuted, which could include GPs or practice managers.
Following the consultation, the DH will publish regulations in draft form to be debated in Parliament, with the aim of producing secondary legislation in April 2014.
The CQC said it is also developing ‘expected standards’, which will incorporate many of the current essential standards it is replacing and will relate to whether a service is safe, effective, caring, responsive to patients’ needs and well-led. These standards will be necessary for CQC registration and will include assessing whether a GP surgery is open at times to suit the needs of local patients.
Inspectors will a use good practice guidance developed by organisations such as NICE to identify whether a service is providing good quality care.
The CQC also reiterated its plans to appoint a chief inspector of primary care, who will oversee a consultation on how GP practices should be regulated and inspected later this year or early next year.
The chief inspector will oversee a team of expert GP practice inspectors which will include professionals with a background in primary care, as well as people with an in-depth experience of using care services.
The fundamental standards were first recommended by Robert Francis QC in his report into failings in care at Mid Staffordshire NHS Foundation Trust, and the Government expressed its support in the response document, Patients First and Foremost.
Commenting on the consultation, CQC chief executive David Behan said: ‘This consultation is a critical step towards making root and branch changes to regulation.
‘These proposals put CQC firmly on the side of people who use services. We have listened to what people have said is important to them about services and used this to form these proposals, but there is a huge amount of detail to decide on before we can move to the next step.
‘We are determined to make the right changes to help us make sure health and social care services provide people with safe, effective, compassionate and high quality care.’
But Dr Brian Balmer, chair of North and South Essex LMCs, said the CQC is going beyond its remit by suggesting standards on opening hours.
He said: ‘The CQC are a regulatory body, not the contracting body. Is opening hours any of its business? Is it their role to police whether people take a lunchbreak, or leave at half seven? I would have thought NHS England already carry out that role and several people trying to do the same job always ends with tears.
‘The CQC haven’t manage to gain the profession’s respect doing what they’re supposed to be doing: inspecting. It’s a very confident organisation that tries to expand into other roles before it’s succeeded in its core responsibility.’
GPC deputy chairman Dr Richard Vautrey said: ‘The CQC needs to focuses on working with practices rather than threatening them.’
A CQC spokesperson said: The consultation published yesterday asks people their views on what the fundamental standards should be for all sectors that CQC regulates. The majority of the rest of consultation focuses on the changes we are introducing in the acute sector.
‘Over the next two years CQC will review and develop changes to the way it inspects other services, including those who provide GP, out of- hours and dental services. Later this year we will publish a more detailed consultation looking at these sectors and we will work with national stakeholders as well as GPs and practice staff in developing these plans. The CQC is committed to making sure whatever we do works and is appropriate and proportionate for this sector.
‘CQC clearly will expect service to be responsive to the needs of the local community. However we will not close a practice just because it is not open at all hours that are convenient to patients.’
This article was modified at 17:40 on 18 June 2013