The CQC has carried out 40 general practice inspections focused on patient access to date – finding there were ‘no current issues’ at any practice.
The focused inspections – which were introduced as part of the Government’s Winter Access Fund plans – took place in November and December, before CQC paused them to allow GPs to focus on the Covid booster programme.
NHS England’s winter access plan had asked the CQC to work with NHS England to ‘make the required improvements across those practices which are not meeting people’s reasonable needs’.
However, at a CQC board meeting two weeks ago (19 January), chief inspector of primary care Dr Rosie Benneyworth told colleagues that no poor patient access had been revealed by any inspection to date.
The winter plan followed months of public and media backlash during the pandemic over the idea that GP practices were closed and GPs were not seeing patients face to face.
The access inspections focus around a series of statements relating to accessibility and do not result in any change in ratings for practices.
In the CQC meeting, Dr Benneyworth said: ‘We undertook 40 of these inspections [looking at access specifically] in November and December and we have currently paused them due to the vaccination rollout.
‘None of the reviews of the locations identified any current issues with patient access. The practices we visited had recognised some previous problems, but had taken action to manage them and improve their systems.’
Despite this, the CQC is now planning on resuming the focused inspections, which currently remain on hold due to the pandemic.
Ms Benneyworth added: ‘We are looking at how we can restart them and align them with the urgent and emergency care work, given the vital role of general practice in the urgent and emergency care pathway.’
Instead of finding issues, the CQC’s inspections found that practices had extended access across ‘vulnerable or digitally excluded’ patients in a ‘variety of ways’.
She said: ‘We saw a lot of good practice in the practices we visited. We saw practices had a variety of ways in which they had ensured patients who are vulnerable or digitally excluded were supported to access the treatment or support they needed.’
The CQC also found that the practices’ response times to e-consultations were ‘very impressive’.
Mrs Benneyworth told the board: ‘We saw a rapid increase in the use of e-consultations with a response time between 78 minutes – which, I think, is very impressive – up to 48 hours, which even given the pressures on primary care at the moment, I think, is impressive.
‘Practices had really structured their workload and appointed extra staff to be able to deal with e-consultations. We found a very small number of recommendations to address, for example updating practice websites to look at appointment availabilities and practice opening times, and some issues around telephony systems and reporting in telephony systems.’
Mrs Benneyworth noted that the inspections revealed the ‘sustained pressure’ general practice is under, with staff working overtime.
She said: ‘I think one of the key things we found is that practices are under sustained pressure. We found staff working regularly over their contracted hours. We saw staff sickness having an impact and we also saw the impact of the self-isolation on practices.’
She added that it is ‘imperative’ the CQC looks at how it ‘arrange[s] services’ to look at ‘new models of care, particularly in advance of next winter’.
It comes as the CQC has this month restarted inspections of GP practices where there is ‘evidence that people are at risk of harm’.
The CQC also admitted its inspection and monitoring methodology ‘may inadvertently disadvantage’ ethnic minority-run GP practices, leading to ‘inequities’.
A previous CQC board meeting in November heard that feedback received regarding primary medical services has significantly increased since the start of the year – by 161%.
At the time, Mrs Benneyworth said the lion share was negative feedback about patient access to appointments.
Dr Dean Eggitt, BMA England GP committee executive team member, commented: ‘Throughout the pandemic, and despite huge challenges, GPs and their teams have been doing everything they can to make sure patients are able to get the care they need.
‘It’s positive to see these efforts recognised by the CQC, not only in finding no problems with access at the practices they inspected, but also in underlining the good work and innovation of practice teams who are looking at new ways to manage demand and improve patient experiences, all while working under the most intense pressure many have ever faced.’
He added: ‘We do appreciate that over the course of the pandemic not all patients’ experiences have been positive, and we are committed to working with patient groups, regulators and policymakers to ensure that where improvement is needed that the approach is supportive and not punitive, taking into account the wider context of demand, workload and workforce pressures that we all continue to work within.’