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Practices forced to spend scores of hours preparing for CQC inspections



Exclusive Nearly half of GPs say their practices are being forced to spend more than 20 staff hours preparing for a CQC inspection, with many spending hundreds of hours, Pulse can reveal.

A Pulse investigation into the true costs of the inspection regime for general practice also reveals that it cost £13.3m from 2014/15, while it is also expected that GPs’ regulator fees could double as the Government seeks to phase of its central funding of the CQC.

The survey of 206 GPs who have gone through an inspection found that practices are using scores of staff hours to make sure they are fully prepared for an inspection by the regulator, with one practice stating that it had spent almost half a million pounds in opportunity costs.

It also shows that practices are on average cancelling 15 patient consultations on the day of inspection.

GP leaders have warned that Pulse’s findings highlight that practices are ‘losing precious time for patient care’ to instead prepare and engage with the CQC’s ‘bureaucratic inspection process’.

This comes as calls from the BMA and the RCGP to scale back the role of the CQC has begun to intensify more than ever before – with the College earlier in the week calling for an ‘emergency pause’ in CQC inspections to relieve pressure on ‘crisis-hit’ practices and avoid a risk to patient safety.

But the CQC’s chief inspector for general practice, Professor Steve Field, instantly rejected the RCGP’s plea, adding that an inspection by the regulator ‘should not be a burden for a well-managed practice’.

The survey found that 48% of GPs spent more than 20 staff hours preparing for an inspection, while 36% spent between 15-20 hours, and 11% spent up to 12 hours on preparation.

However, Dr Thomas Marland is a GP in Poulton-le-Fylde, Lancashire told Pulse that the CQC’s inspection also had a big financial impact on his practice, adding that it would inevitably affect the ‘productivity’ of the practice.

Dr Marland said: ‘We worked out that the whole exercise cost us £430,000, mainly in staff time, but including £15,000 on decorating and cleaning.

‘Staff agreed to take time off in lieu instead of charging overtime, which would have been payable at the weekend rate. But the process has left us with a staggering amount of time owing, so productivity decreases.’

Another GP in Essex said that his practice had paid upwards of £8,000 in fees and preparation to get ready for a recent inspection, while a GP from Woking says his practice spent close to £10,000 to change floors and carpets across three different sites to prepare for inspection.

Dr Chantal Simon, a GP in Oxford, said: ‘Preparation runs into thousands of pounds in practice manager and administrative staff time, not to mention the hours of GP time doing pointless courses to tick boxes – and that is even before we have been inspected.’

GPC deputy chair Dr Richard Vautrey told Pulse that the Government could make savings and improve the quality of care by ‘taking a serious look at what it tasks the CQC to do, and halt GP inspections’.

He said: ‘Whatever the standard of practice, all practices are spending huge amounts of time preparing for and then engaging in this bureaucratic process and therefore losing precious time which is desperately needed for patient care. LMCs, the BMA and the RCGP have made it very clear that this time is not being well spent nor are the millions of pounds spent on this process good value for money.

‘In its quest to make efficiency savings and at the same time improve quality of care, the government should take a serious look at what it tasks CQC to do and put in place an inspection pause whilst we work with them to radically review this system,’ he added.

Survey results

How long did you practice spend preparing for the inspection?

0-12 staff hours 11%

12-15 staff hours 5%

15-20 staff hours 36%

More than 20 48%

How many appointments did your practice have to cut on the day of the inspection?

No appointments 28%

0-10 appointments 14%

11-20 appointments 23%

21-30 appointments 19%

31-40 appointments 10%

41-50 appointments 4%

More than 50 appointments 2%

The survey launched on 9 June 2015, collating responses using the Survey Monkey tool. The survey was advertised to Pulse readers via our website and email newsletter, with a prize draw for a Samsung HD TV as an incentive to complete the survey. Some 206 GPs answered these questions.