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CQC’s ‘risk ratings’ are incredibly damaging – they must be withdrawn

The CQC needs to take a long, hard look in the mirror and ask what it is for.

The publication of its ‘risk rating’ scores for GP practices has unleashed yet another media feeding frenzy – the very last thing GPs need as they struggle to keep their practices afloat.

Seemingly having learned nothing from the notorious ‘maggot-gate’ incident – in which a practice was hauled over the coals for a few harmless critters lurking in a distant corridor – the regulator’s press department has delivered yet another demoralising punch to the gut of general practice.

The CQC stresses the indicators do not amount to a ‘judgment’ of practices and that the ratings will help it prioritise inspections. Try telling the Daily Mail: ‘GP SURGERIES: 1 IN 6 IS FAILING’ read their front page.

Hard-working GPs and their practice staff come into work every day to do their best for patients, despite plummeting funding and a crippling workload. If the CQC is intent on fuelling the all-too familiar media vilification, it might as well light a bonfire under the whole of general practice.

The publication of a ratings scheme the CQC itself openly admits is not fit for determining bad practice is inexplicable. ‘We will use our analysis of these indicators to raise questions, not make judgments, about the quality of care,’ it insists. But, if so, why release them to the media? It defies belief that the CQC has consulted on, piloted and launched an inspection programme only to undermine it by publishing alternative ratings in which it has little faith itself.

GP practices lack control over many of the 38 indicators and, as our analysis shows, they can present a misleading picture of the quality of care. For instance, it is widely accepted that deprivation is one of the most important drivers of emergency admission rates, and practices cannot force patients to attend cervical cancer screening or have a flu jab. It is invidious to red-rate practices on ‘expected’ levels of dementia and COPD rates, when there may be good reasons why the levels are the way they are.

The use of the word ‘risk’ is utterly irresponsible when anyone could have predicted that national journalists would use it to scare patients. The CQC website has an astonishing lack of information to help patients make sense of the ratings, yet illustrates shortcomings with a big red circle and an exclamation mark. 

Pulse spoke to one practice that had no idea the local paper had picked up on its CQC risk rating and was asking patients to comment on their concerns. ‘But the CQC has not even been here,’ said the harassed practice manager. ‘How do they know?’

I have a message for the CQC. You say these ratings should ‘prompt GP practices to ask questions, reflect and take action in respect of their own performance’. I urge you to do the same.

If your mission is to improve patient care, you need to withdraw these ratings. You have demoralised an entire profession, and that is bad for patients, bad for practices and bad for the future of the NHS.

The chief inspector of general practice often says he is the biggest champion of general practice but actions speak louder than words. Apologise for publishing the ratings, admit they are misleading and take them down from your website.

Admitting mistakes, reflecting and learning are signs of a well-led organisation, are they not?

Nigel Praities is editor of Pulse