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CQC specialist adviser quits role due to disillusionment with inspection process

Exclusive A practice manager has resigned as a CQC specialist adviser in protest over the oppressive culture that they say sits at the helm of the regulator. 

Shaun Chadwick, practice manager at Westcotes GP Surgery, handed in his resignation last month after admitting he can no longer work for an organisation whose direction is to ‘catch out hard-working GPs who are propping up the NHS’. 

Mr Chadwick, who took up his position in 2015, told Pulse that the current CQC inspection approach is inconsistent and punitive, and has failed to support failing practices.

Earlier this year, in its annual report on the state of health and adult social care in England, the CQC said that a ‘large group of GP practices’ have deteriorated to a lower rating due to ‘ongoing capacity pressures’. 

But in an exclusive interview with Pulse, the watchdog’s new chief inspector of primary care said the CQC is ‘not going to be making any concessions’ for GP practices during inspections, despite acknowledging the ongoing pressures facing the profession.

Mr Chadwick revealed his decision to resign ahead of an upcoming focused inspection after Westcotes GP Surgery failed to comply with a number of regulations. 

He said: ‘After years of service at CQC, […] I no longer wish to be associated with an organisation I don’t trust and has such an unjust and inconsistent approach towards regulation.

‘It’s a shame that CQC can’t see that punitive measures and lengthy reports, achieve nothing of real benefit, and are actually counterintuitive by driving people away from the profession thus deepening the NHS crisis.’

Westcotes GP Surgery was rated inadequate in October for not providing safe, effective and well-led services. 

At the time, the CQC team raised concerns over the practice’s failure to comply with requirements and regulations, including not having certain medicines in stock and poorly managing clinical cover for annual leave and staff sickness. 

In a series of emails seen by Pulse, Mr Chadwick told the CQC that some of the accusatory points highlighted in the regional GP specialist advisor’s report were misleading and incorrect, before he announced his decision to resign as specialist adviser.  

Mr Chadwick said he feared the same specialist adviser might attend the upcoming inspection, which could further impact the practice’s efforts to address the ‘real concerns’.  

He said: ‘Under the new chief inspectors and new regional specialist advisors, I consider my position untenable. It doesn’t sit comfortably that CQC’s new direction is to catch out hard-working GPs who are essentially propping up the NHS.

‘They penalise practices for such things as recruitment issues when in reality, GPs don’t want to be working 14-hour days either, nor is it their fault that there is a recruitment crisis.’

‘In my view, CQC is eroding the goodwill of the remaining GP workforce.’

Mr Chadwick said he believes CQC inspectors do not operate under an objective framework when assessing a practice, which in turns leads to ‘variation in assessment and inconsistency in the output report’. 

In response, the CQC said the practice had an opportunity to challenge its inspection reports before publication but added it remains committed to working with the staff to help them improve. 

CQC chief inspector of general practice Rosie Benneyworth said: ‘Our inspections continue to follow a consistent approach and a clear methodology which was developed through consultation and conversations with the profession and is publicly available. Furthermore, they are carried out by dedicated and experienced inspection teams who work to make sure people have access to the safe, high-quality care that they deserve.’

She added: ‘Inspection reports are also subject to factual accuracy review from the practices themselves and are open to challenge before being published.

‘These challenges, or any other, were not raised during factual accuracy or by the registered manager of Westcotes GP Surgery, and we will continue to work with them and the practice team in good faith as they work to deliver their clear vision for the surgery which we noted in our report.’

Pulse reported last week that the CQC will have to reinspect almost 70 adult and social care services in England after if found duplicate material in over 100 reports

In July, the BMA called for the CQC to review how they process complaints and inspections, arguing that there is no evidence to suggest ‘our system of regulation at a personal level or provider level actually leads to improved safety’.

Meanwhile, the CQC said its new approach of phoning highly-rated practices every year instead of inspecting them as often had helped to ‘build relationships between inspector and practice’.