Exclusive GP leaders have asked whether the CQC ‘can be trusted’, after the regulator claimed that there was no opposition to its ‘motivating’ Ofsted-style ratings system for GP practices, despite long-standing warnings by the GPC.
The regulator made the claim in an interim summary report on the consultation about the new inspection regime, but GPC deputy chair Dr Richard Vautrey said it had ‘ignored’ the GPC’s ‘serious concern’ about the new ratings.
He warned the ratings could further deepen the GP recruitment crisis in certain areas of the country by starting a ‘spiral of decline’, while LMC submissions said they were ‘very complicated’ and were ‘aspirational’ in the current climate.
But the CQC said that there was no opposition for the ratings system, and even claimed that they were ‘helpful’ and ‘motivating’ to practices.
Dr Vautrey told Pulse that GPs will ask ‘whether they can trust’ the CQC following the claims and the ‘twisting’ of the practice reports last year, which saw one practice challenging claims that it had an infestation of maggots.
A CQC spokesperson admitted the summary disregarded the GPC submission, but that this was because it was only an interim report, with the full response to the outcome of the consultation to follow in October.
But according to the summary itself, it included all responses from ‘health and social care providers, stakeholders, our staff and members of the public including local community and voluntary groups’ up until the 29 May.
This was after the LMC conference, held on 22-23 May, voted unanimously in favour of a motion ‘vehemently opposing’ the ratings system.
Under the new system, introduced at the end of April, practices will be given 42 ratings relating to six different domains relating to different groups of patients, such as elderly people and children and families, similar to those ratings used by Ofsted for education organisations.
Practices will need to publish these – including an overall rating for their practice – in their waiting rooms and on their website from October, when the system is fully functional following the current pilot period.
The regulator concluded that the ratings element of the new regime had been supported by all parties.
Its summary said: ‘Overall, there have not been major challenges to the features of our proposed new regulatory model. For example, people have not opposed the idea of introducing ratings and many think that having a description of what good care looks like for each of the services we are looking at is helpful and, in some respects, motivating.’
But Dr Vautrey told Pulse: ‘The BMA represents over 150,000 doctors and for CQC to report that they had received no concerns about their simplistic and potentially damaging rating scale is to completely misrepresent the consultation responses.’
‘GPs will question whether they can trust an organisation that twisted their inspection report last year to gain headlines about maggots in GP consultation rooms – which turned out not to be true – and are now saying that everyone supports their rating scale when quite clearly that is not true.’
He added that this will exacerbate the recruitment crisis, which has even hit the practice of Professor Steve Field, the chief inspector of primary care, it was revealed today.
He said: ‘Their rating scale risks making recruitment and retention worse in under-doctored areas as morale falls further with hardworking GPs struggling to recruit to maintain services. Young doctors will not want to risk their reputation by working in practices when there is an official body saying that they are failing. These practices risk a spiral of decline often through no fault of their own.’
Dr Vautrey accused the regulator of ‘spinning’. He said: ‘If CQC are to gain the respect of the profession they need to be open and honest and work in a way that recognises the financial and workload pressures practices are under, and not fall in to the trap of spinning things to suit their agenda.’
The consultation submission from the GPC had said: ‘We have serious concerns about the way in which the CQC rates services. We do not believe that one overall rating can adequately capture the complexities of delivering healthcare and urge the CQC to carefully rethink the way in which rating information is communicated to both staff and the public.’
It was not the only response to raise critique with Cambridgeshire LMC warning that the ratings scheme was ‘overly onerous’.
In its submission, the LMC said: ‘The proposed new system appears to be overly onerous with a very complicated rating process […]Once again, many of the outstanding ratings cannot be achieved without appropriate funding. The ratings process appears to be entirely aspirational in the current climate.’
A CQC spokesperson said: ‘The interim summary published on the CQC website is based on the views of members of the public, providers, staff, local voluntary and community groups (e.g. Local Healthwatch). It does not include the views of larger stakeholders such as the BMA, whose comments, along with more detailed responses from members of the public and individual professionals will form part of our overall response to the consultations which we will publish in October.’
‘The summary on the internet reflects views from events we held across the country for health and social care providers, stakeholders, our staff and members of the public including local community and voluntary groups that represent them.’