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Practices will have to pay to access additional support to get them out of CQC ‘special measures’



Exclusive GP practices will have to stump up half the cost of essential support for when they are placed in ‘special measures’ by the CQC, Pulse has learnt.

NHS England is working with the RCGP to develop a 12-month ‘intensive peer support’ pilot programme for practices that have been found ‘inadequate’ in some areas by the CQC’s new inspection regime, and is designed to prevent them from having their registration removed.

However, NHS England said that practices placed in special measures will have to contribute half the costs – which are as yet unknown – for the support package.

GP leaders have said that the majority of practices who are found to be inadequate are likely to be underfunded anyway, and that charging practices who need support could lead to further practice closures.

It comes after the CQC recently revealed that GP practices that are judged ‘inadequate’ in a number of areas by the new CQC inspections, which will begin in October, 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.

NHS England has said that it is working to develop a framework for local area teams that outlines how they will develop a plan for practices rated ‘inadequate’ or placed in ‘special measures’ to ensure progress is made before a re-inspection.

A spokesperson for NHS England said: ‘NHS England has already begun work to develop an operating framework for area teams that describes how they work with CQC pre inspection, during and post inspection; how they work with practices rated as “inadequate” or those placed in “special measures” to develop an improvement plan, and how they oversee and monitor this plan to ensure measurable improvements are made ahead of any re-inspection.

‘NHS England is also starting work with the RCGP to develop a 12-month pilot programme of intensive peer support to practices that are placed in “special measures”. The programme will provide quality assured expert support from the RCGP and will enable practices to access a flexible package of direct support, mentoring and coaching.’

However, it added: ‘It is expected that practices that choose to take up the support offer will only have to contribute half the costs.’

‘The pilot will run from October 2014 to October 2015 and will enable NHS England to identify how best to support practices in rapidly restoring the quality of the services they provide to local patients.’

The chair of the GPC’s contracts and regulation subcommittee, Dr Robert Morley, warned that paying costs for support would be the ‘final straw’ for practices.

He said: ‘I can’t see this having anything other than unintended consequences. It’s disappointing that practices already struggling, many of them through no fault of their own, following a decade of lack of support and investment by PCTs and NHS England, should then be expected to have to pay themselves for the support and investment required for them to be allowed to stay in business.’

Dr Morley said that the majority of practices found to be in need of special measures ‘will be those who have both suffered most from historical underinvestment and practice in the most challenging areas with the most vulnerable patients’.

He added: ‘The inevitable outcome, I suspect, is that the practices involved will simply either not be able to afford this or, for the GP partners, it will simply be the final straw and they will hand in their resignations. The end result, of course, will be yet further practice closures to the detriment of those patients most in need of more and better GP services.’

The CQC’s chief inspector of general practice, Steve Field said: ‘The CQC would expect GPs who are put in special measurers to take whatever steps are necessary to make the required improvements to become compliant. We are delighted that the RCGP and NHS England are working closely to support GPs, I also believe that LMCs will have an important role to play with their local practices.’