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Professor Clare Gerada’s letter to the CQC on restarting GP inspections

Dear Dr Rosie Benneyworth, 

I am writing to ask you to reconsider your decision to restart GP CQC inspections and urge you, for the sake of the mental health of the GP workforce not to, and to delay by at least 12 more months.

As the medical director of Practitioner Health, I have, for some time, been raising concerns about the mental health of general practitioners, which even before Covid-19 was very poor. Going into the pandemic GPs were exhausted, burnt out, demoralised and depressed. The impact of Covid will only exacerbate these problems as is already evident by referrals to our service.

We are at the beginning of the first recovery phase from Covid-19. The NHS as a whole is faced with re-prioritising and rescheduling work and practices are now having to adjust to working in new ways. As you can appreciate this is very challenging and even now systems are not fully embedded and to inspect now seems unreasonable.

It will at least take one pressure off an already psychologically traumatised profession

Furthermore, practices with a diminished workforce capacity are dealing with enormous unmet need compounded by a backlog of reports, referrals, and work, suspended due to the pandemic. They are also preparing for an inevitable second spike. Medicines and chronic disease reviews will now be at least three months behind. Screening has stopped and is only re-starting on a limited basis.

Staff development, including internal and external appraisals, have not been possible and have been deferred. This is not an inclusive list but illustrates that putting GPs through the additional pressures of having to prepare for an inspection might tip some of them over the edge of despair, leading to resignations and early retirement as well as a surge in mental illness amongst them. It also distracts from the task in hand – patient care and returning services to some sort of normality for patients.

GPs and their teams now need to re-group, to mourn the loss of friends, family and colleagues and to have a period of reflection to help them digest what they have been through and in so doing be in a position to support their staff and patients. They do not need the added work, distraction and psychological burden of preparing for an inspection, no matter how limited.

I urge you to seriously consider my request as it will at least take one pressure off an already psychologically traumatised profession.

Professor Clare Gerada MBE is medical director for NHS Practitioner Health