Exclusive GP practices have spent an average of more than £2,500 on preparing to register with the CQC, despite the regulator insisting it does not expect practices to spend any additional funds, a Pulse survey reveals.
Our poll of 273 GPs shows over half have spent more than £1,000 preparing for CQC registration, including staff time, while more than one in ten have spent over £5,000.
If the average costs are extrapolated to cover all 8,300 practices across England, this would mean the profession has spent a total of £21,090,300 preparing for registration from 1 April.
The GPC said it was ‘concerning’ practices were spending this money at a time when resources were dwindling and many were looking at how they can maintain patient services under the terms of the new GP contract for 2013/14.
The survey findings follow several reports of overzealous PCTs using CQC registration to force practices to make expensive changes, with one surgery told recently by NHS managers that it must have a £300,000 refurbishment in order to prepare for CQC inspection. Last year it also emerged more than 1,000 practices had spent hundreds of pounds each on software to prepare for CQC registration.
The survey found practices spent an average of £2,541 on preparing for registration. Some 16% of GPs said they spent nothing at all, but 71% said they spent anything from up to £500 to more than £5,000 on getting the practice ready.
On average practices have spent an average of 7.4 staff days preparing for registration. Only a minority (3%) said they had spent just one day or less.
All practices are expected to be registered with the regulator from 1 April, although two practices have been served with closure notices by the CQC.
GPC deputy chair Dr Richard Vautrey said the findings showed how seriously GPs were taking CQC registration and how worried they were about the prospect of inspections.
He said: ‘It’s concerning that practices are spending money they can ill afford at a time when resources are being squeezed.’
‘This is yet another initial cost they’re being squeezed for, when the Government hasn’t accepted the DDRB’s recommendations about an uplift to GP funding.’
‘Some practices have been unduly worried – we’ve heard reports of [GPs] being ordered by the PCT to refit their practice for infection control, which turned out not to be the case. But until inspections start they won’t have a benchmark against which to measure themselves.’
‘They can’t afford to wait to find out because their future livelihood depends on their practice.’
Dr Peter Swinyard, chair of the Family Doctor Association, said in his small practice preparing for registration took two days of his time and five days of his practice manager’s time.
He said: ‘In cost terms, two days of my time to replace me is £1,200. And five days of my practice manager’s time… we pay £33,000 for a 44-week year. So you can work out the expense.’
He added: ‘A few days ago at a small conference I asked for a show of hands on who thought that a single life will be saved by the CQC. Not a single hand went up. We’re talking about a low risk environment. It’s one regulator too far. Stepping up the regime in light of the Francis report wouldn’t be very wise. We don’t starve our patients in general practices, nor do we leave them in soiled beds.’
Dr Stephen Gardiner, a GP in Somerset, said that that CQC registration had been a considerable burden.
He said: ‘One month of our manager’s time investigating what is expected reasonably and drawing up and collating protocols; at least four hour-long partners’ meetings going over it all; several hour-long staff meetings plus regular email updates.’
‘Some of it has been useful in terms of dotting “i”s and crossing “t”s and centralising all of the information. However the cost of this benefit has been enormous and things weren’t going wrong beforehand. Most of the expense was staff time – we are pretty well equipped and we have always had quite high expenses. It’s about the workload involved in it.’
A CQC spokesperson said: ‘We’d expect all practices to be safe and hygienic. We haven’t required GPs to spend money to do this.’
‘We’ve tried through working with GPs, particularly through the online registration process we’ve set up, to reduce the time that needs to be spent on registration and have always been available for advice.’
Amount spent on CQC registration
£0 16% of GPs
£0- £499 13% of GPs
£500- £999 15% of GPs
£1000- £4999 40% of GPs
£5000- £10,000 16% of GPs
GPs spent an average of £2540.87
Time spent on CQC registration
0 to half a day 12% of GPs
Half a day to one day 3% of GPs
Two to five days 21% of GPs
Five to ten days 27% of GPs
Ten to fifteen days 37% of GPs
GPs spent an average of 7.41 days on CQC registration
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Pulse Live: 30 April – 1 May, Birmingham
Stephen Dorrell, chair of the House of Commons health select committee, will be talking about where general practice will fit into the NHS of the future at Pulse Live, Pulse’s new two-day annual conference for GPs, practice managers and primary care managers.
Pulse Live offers practical advice on key clinical and practice business topics, as well as an opportunity to debate the future of the profession, and a top range of speakers includes NICE chair designate Professor David Haslam, GPC deputy chair Dr Richard Vautrey and the Rt Hon Stephen Dorrell MP, chair of the House of Commons health committee.
To find out more and book your place, please click here.