The CQC has indicated for the first time that it could move to a more ‘light touch’ regulation of GP practices.
It is expected that this new approach would be initiated by introducing ‘place based inspections’, which would see the regulator focusing on whole areas to see why practices are performing poorly, a report by the Health Service Journal has claimed.
He also said he was ‘not at all surprised’ at the opposition of the CQC’s new inspection regime from the GP profession, because it was a ‘sector that has never been regulated’.
Professor Field proposed the introduction of more focused, and less frequent inspections of GP practices – adding that if 80% of practices are rated as ‘good’ – then resources could be better spent ‘encouraging improvement’ in practices with known problems.
However, Professor Field also indicated that there would be no major change to GP inspections before all practices have been rated once. The CQC had been planning to inspect all practices by September 2016, but there have been suggestions this target would not be met.
The move to introduce ‘place based’ inspections form as part of the CQC’s new ‘quality of care in a place’ pilot to assess ‘whole health systems’ – as part of a step towards an area based approach to regulation.
As part of the pilot, the CQC will inspect whole health systems in Northern Lincolnshire and Greater Manchester – however, Professor Field insisted that the regulator will still look at individual providers and no extra inspections would be carried out as a result of the pilot.
It will also specifically look at the experiences of the elderly and people needing mental health care to see whether analysis of different population groups is helpful in building a picture of the system as a whole.
The findings of the pilot will feed into the regulator’s strategy for the next five years, which CQC is currently developing.
Professor Field said: ‘If we’re looking at, say hospitals and GPs, if 80% of [GP practices] are “good” on our current ratings, are resources better spent looking at those which aren’t as good, and encouraging improvement, and having a more light touch [approach]?’
The CQC’s move to a ‘more light touch’ approach of regulating GP practices follows strong opposition of the new GP inspection programme from both the GPC and RCGP.
At the LMCs conference in May this year, a motion was passed calling for the abolition of the CQC, while the GPC chair Dr Chaand Nagpaul said that the regulator’s rating system of practices should be scrapped.
A CQC spokesperson told Pulse: ‘We have started work on our strategy for the next five years looking at how we regulate health and social care services in England. That work will look at a whole range of options for the future of regulation, including whether there is a role for CQC to report on the quality of care across local areas as well as how we prioritise our inspection activities.
‘We will carry out a full consultation on these options early next year.
‘Our focus remains on monitoring, inspecting and rating all general practices using our existing approach.’
Former RCGP chair and a GP in Lambeth, Professor Clare Gerada, said: I think what the CQC are picking up on is issues that are way beyond GPs’ control; like premises investment and staffing levels – they further beat us by telling us the barn door obvious that there is no money to improve premises and no staff to deliver care.
‘So, I think if they really are going to do a light touch, then that’s what the RCGP has for years been asking for – and they need to abolish this star rating system that they’ve got – it’s just nonsense and measures things outside our control and I think they should focusing on the bottom 5-10% of practices.
‘I’d like to give credit to the RCGP because I know they have been working very hard behind the scenes to achieve this.’