Exclusive: Every GP practice in England will be forced to undergo a surgery inspection by the Care Quality Commission once every two years, the regulator has disclosed.
The surgery visits are likely to last between half a day and a full day and may include interviews with practice staff and patients. They will assess GPs against key quality standards, with the resulting report published in the public domain.
The plans were revealed in an exclusive interview with CQC national clinical adviser Professor David Haslam just days after MPs warned the regulator it risked being little more than a ‘postbox’ for GP applications and urged it to tighten its inspection processes.
Registration with the CQC will see practices assessed against 16 ‘essential standards’ including cleanliness, treating patients with respect and whether practices have the right number of qualified staff.
GPs will apply for registration with the CQC between September and December this year and will be subject to inspections from next April. The CQC will test the inspection process this summer with 40 pilots involving GP practices of different sizes. CQC officials recently told MPs up to 10% of GP practices would be inspected in person because they could ‘present a significant risk of non-compliance’.
But Professor Haslam, a former chair of the RCGP and previously a GP in Huntingdon, Cambridgeshire, said: ‘The plan is almost certainly that once every two years there will be a planned visit to every practice.’
Professor Haslam said inspections would focus on patient experience and could involve interviews with practice staff and patients, although inspectors would not sit in on consultations. He warned partners would be held to account if staff were found not to be up to speed on issues such as patient safeguarding or how to respond to suspected child abuse.
The inspectors were likely to be ‘generic’ professionals skilled in inspecting rather than clinical care, although GPs could be recruited as advisers to the process, he said.
GPs will always be warned about routine inspections, although inspectors will have the power to conduct spot checks if the CQC has concerns about a practice, based on information from the GMC, patient groups, whistleblowers or media reports.
Professor Haslam said it was unlikely the CQC would immediately shut down or suspend a practice following an inspection, except in extremely serious cases: ‘We wouldn’t say: “This isn’t good enough, shut your doors and leave the patients uncared for.” But we do have the clout to expect change to be delivered.’
After an inspection report is completed, GPs will have a chance to see it before it is published on the CQC website – but only to check factual accuracy.
Professor Haslam sought to reassure GPs: ‘We won’t be asking for reports on this and protocols on that. Our entire ethos is built around patient experience. As long as we believe patients are receiving good care, the amount of information we need will be very small.’
But Dr Richard Vautrey, GPC deputy chair, said: ‘Practices are already visited on a regular basis by PCTs and others. If the CQC has any concerns, then clearly they need to be picked up. But the frequency of visits in itself could be a huge burden, not just for practices but also for the CQC when you take into account the number of practices involved.’
Dr Amir Hannan, a GP in Hyde, Greater Manchester, said the value of CQC inspections would depend on whether they led to better outcomes: ‘If it just becomes another tick-box exercise, then what will we have achieved?’
How the inspections will work
- Inspectors set to interview staff and patients
- Likely to last between half a day and a full day
- Inspection reports to be published online