Exclusive The CQC is issuing threats of criminal prosecution or £4,000 fines to practices who fail to provide up-to-date details of their ‘registered manager’.
A template letter, which has been circulated to LMCs to pass on to their practices, warns that the CQC ‘have grounds to suspect you have committed a criminal offence’ by ‘failing to comply with the conditions of your registration’.
These conditions include ensuring that regulated activities – including ‘treatment of disease, disorder and injury’ – is ‘managed by an individual who is registered as a manager in respect of that activity’.
The BMA’s GP committee condemned the ‘extremely threatening’ letters and said it was regrettable that CQC had decided to send them to practices as a first notice.
Local GP leaders have warned that CQC is currently focussing its attention on the ‘Central’ England region but that practices in the rest of the country should take note and ensure their details are current and correct.
The CQC told Pulse that having a registered manager is a requirement for practice’s registration and was key to ‘effective leadership’.
It added that the tone of these letters was intended to make clear that failing to do so was an offence but practices were invited to explain the breach, and where it could be justified then no further action might occur.
In Essex the LMC circulated a template version of the letter, which is headed ‘IMPORTANT – CONCERNS CRIMINAL OFFENCE’ and warning that it has ‘been sent to a number of practices in CQC’s central region.’
It begins: ‘We are writing to you as the registered provider as we have grounds to suspect you have committed a criminal offence. The offence is an offence of failing to comply with the conditions of your registration (Section 33 of the Health and Social Care Act 2008).
‘This offence can be dealt with by way of a fixed penalty notice (£4000 fine) or a prosecution (unlimited fine).’
Regarding the offence in the case of the template letter, it states: ‘A condition of this registration was that you as the Registered Provider must ensure that the regulated activity, diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures, treatment of disease, disorder and injury is managed by an individual who is registered as a manager in respect of that activity.’
Failing to respond means the case ‘will be referred to a decision-maker to decide whether to issue a fixed penalty notice or progress to a prosecution.’
Sandra Acott, a practice manager in Pitsea, Essex received the template from her LMC and she told Pulse she was ‘very angry’ that already stretched practices could receive such a letter.
She said: ‘Having a registered manager in place is purely an administrative exercise. Having this up-to-date information on the CQC website (or not) will not make any difference at all to how GPs, nurses and practice staff look after their patients and is that not what our sole purpose is?’
The contracts and regulation lead for the GPC, Dr Robert Morley, said he didn’t know how many practices had been contacted by CQC but he told Pulse: ‘The extremely threatening tone and content of these letters is very regrettable, and also highly ironic in the context of the appalling performance hitherto of CQC’s registration processes. GPC has taken this up with CQC’.
Ruth Rankine, deputy chief inspector of general practice at the CQC said the letters ‘are not a fine in themselves’ and that where practices can show ‘good reason for the breach it may go no further’.
She added: ‘Having a registered manager is both a legal requirement for most providers and an important part of establishing effective leadership. Effective leadership is vital to patients being offered the good care that they deserve, and is something that we have seen in our inspections of general practice.
‘When CQC has reason to believe that a provider is not meeting the conditions of their registration, such as having a registered manager, we contact them to get to the bottom of the issue and also outline the extent of our enforcement powers which, as with other breaches of regulatory requirements, can in severe cases include prosecution. Where we fail to get a satisfactory response, a formal letter will be issued.’