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CQC targeting vulnerable children’s GP records in review of safeguarding policies

Exclusive The CQC is looking at the GP records of the most vulnerable children as part of an inspection programme of child safeguarding policies without consent, Pulse can reveal.

The CQC is conducting inspections of health services within local authority areas in England – which will include GP practices – for child safeguarding and looked after children, carried out by inspectors from the CQC’s children’s services inspections team.

The inspections of the medical records, which has been ongoing since September 2013 and will finish in April 2015, came to light after Pulse last week revealed that CQC inspections teams, including the lay members, will have the power to review patient medical records on the new GP inspections ‘to assess the quality of care provided by the practice’ – without their consent.

The CQC said that GPs will be asked whether to take part in the review of child safeguarding policies, and said it will be talking to ‘approximately five to ten’ GPs in each CCG area.

But GP leaders warned that the inspections should be halted immediately, as they risk jeopardising the relationship between GPs and their most vulnerable patients.

The CQC has powers to access patient medical records, which falls under Health and Social Care Act 2008, and Pulse reported in 2012 that CQC inspectors routinely accessed GP records without patient consent during a pilot of 40 practices to test the regulator’s model for inspecting practices.

In a letter sent to south London CCGs this week, the CQC said it will be looking at individual children’s health records, adding that it will also ‘dip sample’ additional areas where it requires further evidence of the range of quality of work undertaken.

The regulator claims that accessing children’s records ‘allows inspectors to assess the response to children in different circumstances and how those services work together to keep children safe.’

The main focus of the inspections programme is to evaluate the quality and impact of local health arrangements for safeguarding children, thus aiming to improve healthcare for children who are looked after.

The letter sent to south London NHS CCGs states: ‘Our case tracking activity will involve visiting local services to talk to a range of health professionals and sitting with them to review their work with individual children and young people.

‘This includes reviewing individual children’s health records. We will also “dip sample” additional records in areas where we require additional or further evidence of the range of quality of work undertaken.’

But Professor Clare Gerada, former chair of the RCGP and a GP in Lambeth, has called for the CQC to halt accessing children’s records without consent, adding that the patient and GP relationship ‘risks being lost’.

She told Pulse: ‘I am concerned that CQC seemingly can “dip into” the case records of some of most vulnerable families without their consent. It can be a difficult task gaining the trust of these families and my concern, as a GP looking after these patients is that hard won trust risks being lost.

‘I think that until GPs get clarity on the legal and regulatory confusions concerning access to records CQC should halt accessing them without prior informed patient and where needed, third party consent.’ 

A spokesperson from the CQC said: ‘Safeguarding inspectors look closely at the experiences of children and young people who need help or protection and the quality of services provided to looked after children. The structured sampling of case records across all health services allows inspectors to assess the response to children in different circumstances and how those services work together to keep children safe.

‘Cases are tracked and where this raises questions about specific areas of service provision in the locality, this is followed through as part of the inspection. In this way the findings follow the journey of the child and recommendations focus on those services where improvements are needed.’

It comes as the CQC officially launched its new inspection regime of specifically GP practices at the start of October, and the recent publication of its handbook on how practices will be given ‘Ofsted-style’ ratings.  

Practices will be given an Ofsted-style rating of either outstanding, good, needs improvement, inadequate for a total of 42 ratings which will have to be displayed in the practices and on the website alongside their final score.

Pulse recently revealed that the CQC also plans for inspectors to sit in on GP patient consultations as part of the new inspections regime, and the regulator is planning to publish individual practices’ data on GP prescribing of antibiotics and benzodiazepines.