GP practices that fail to display their CQC ratings will be charged up to £600 from April 2015, under new proposals announced by the Department of Health today.
The Department of Health has proposed that it should be a legal requirement for practices to clearly display their CQC ratings, adding that providers which receive a poor rating are ‘less likely’ to publicise their score.
In the consultation document, Display of Performance Assessment, it states that GP practices will be expected to display their CQC rating in the reception area, waiting room or the main entrance of the surgery – and that there is ‘no reason’ why a surgery shouldn’t display their rating in all of these locations to ensure ‘maximum visibility.’
But the GPC has warned that the Department of Health’s proposals could further damage the GP recruitment crisis, claiming that GPs are less likely to join a practice with a low rating – further ‘widening health inequalities.’
It comes as the CQC is set to begin its new inspection regime of practices in October, where the CQC will determine practices’ ratings across six patient groups, five key questions and combinations of each.
These will feed into the practice’s overall rating, which can be ‘outstanding’, ‘good’, ‘needs improvement’, or ‘inadequate’.
At present, although there is a contractual obligation for practices to display their ratings, there are no regulations or punishments set out for not doing so.
However, the Department of Health has proposed that this new requirement would be enacted through the regulations of the Health and Social Care Act 2008, and as part of the CQC Registrations Regulations 2009.
Despite the move to make it a legal requirement for practices to display their rating, it will be up to the providers’ discretion on how the rating should be displayed – and for the CQC to determine whether the steps taken by the practice have been sufficient.
The report states: ‘We want to ensure that providers display their rating, and that there are appropriate penalties for not doing so. We propose that the penalty for not displaying the rating should be an offence with a maximum penalty of a level two fine on the standard scale (currently £500). In addition we propose that CQC should be able to issue a £100 penalty notice in lieu of prosecution.
‘We expect providers to consider where displaying the rating at a premises will be visible to the most people and if necessary, check with the people who use their services as to whether they were aware of the rating being displayed. For example: at a minimum at GP surgery should have the rating clearly displayed at reception or in the waiting room or at the main entrance of the surgery. However, there is no reason why a GP surgery could not display the rating at all of these locations to ensure maximum visibility, rather than rely on a single display.’
Health minister Norman Lamb said in the preface to the consultation: ‘The public should have ready access to how well a provider is doing and this means provider’s being upfront about the rating CQC has given them. So when a patient or member of the public looks online or walks through the door of their local hospital, GP surgery or a care home, they can see a clear rating of how safe and effective that service is.
‘I am sure that providers who are awarded a “good” or “outstanding” rating by CQC, will want to highlight their achievement. Providers who receive a “requires improvement” or “inadequate” rating are less likely to wish to publicise this fact.’
However, GPC deputy chair Dr Richard Vautrey warned that forcing practices to display their ratings could make GP recruitment and retention worse – consequently extending ‘health inequalities.’
He added: ‘GPs have real concerns that the proposed CQC rating system will not help patients make an informed decision about the quality of care a practice provides and will end up being discredited as the previous star rating system for hospitals was.
‘Practices that receive lower ratings may do so for reasons that are out of their control and more related to the challenges of the population their serve or the inadequate support they’ve received to deal with premises problems. It risks making recruitment and retention worse as few GPs will want to join a practice that is rated as being worse than others, so widening health inequalities as a result.’
As part of the new process, practices that are judged ‘inadequate’ in a number of areas by the new CQC inspections will be placed in special measures after six months. The special measures will allow the CQC and NHS England to oversee the practice and set out clear expectations for improvement, but if there are no sufficient improvements within a further six months, the practice will have its registration removed.
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