Exclusive: CQC 'outstanding' rating up to five times more likely for practices outside London

Practices in the north and east of England are five times more likely to be rated outstanding by CQC inspectors than those in London, exposing a 'history of lack of investment' in the city.

Some 5% of GP practices in the north of England and the Midlands and East NHS regions, and 4% in the south of England region, have been rated outstanding by the CQC in its first round of inspections – compared to just 1% in London.

GP leaders said the disparity was likely a result of sustained low investment, warning the results demonstrated the ‘essential need’ for long-term investment in general practice.

The results come as all practices registered when the rating system was implemented have been visited at least once, although some ratings reports have yet to be released.

Map: GP practices rated outstanding by the CQC

Overall across England, over 250 practices have been awarded outstanding ratings following inspection, around 4% of the more than 6,000 inspected. Almost 90% of practices overall have been awarded outstanding or good CQC ratings.

Practices in the north of England are the least likely to receive a ‘requires improvement’ rating, coming in at 6%. This is followed by the south of England with 9%, Midlands and East with 11% and finally London with 16%.

Just 2% of practices in the north and the south of England currently have ‘inadequate’ ratings, along with 3% in the Midlands and East and 4% in London.

GPC deputy chairman Dr Richard Vautrey said the results laid bare the historical lack of investment in the infrastructure of practices in London.

GP funding

‘There has been a long history of lack of investment into the infrastructure of practices in London and issues relating to lack of support offered by successive local primary care organisations in London,’ he said.

‘What this demonstrates is the essential need for long-term sustained investment into general practice right across the country.’

Dr Michelle Drage, chief executive of Londonwide LMCs, said: ‘London’s GPs and their practice teams face a unique set of challenges that make like-for-like comparisons with the rest of the country difficult.

‘With very limited resource they are caring for an incredibly diverse and highly mobile patient population, with large areas of social deprivation and the multiplicity of health problems that accompany it.

‘London practices are delivering high quality care to their patients, despite under-resourcing and high levels of staff vacancies. Inspection regimes alone do not improve care, addressing the root issues of living costs and other barriers to recruitment of GPs, nurses and practice staff should take priority.’

Professor Steve Field, chief inspector of general practice, said: ‘After reporting on more than 6,000 inspections we have found that most care is good – with over 200 practices now rated outstanding.

‘That means that over 1m patients in England currently receive care from practices that we have rated outstanding. What’s enormously encouraging is that our inspections are driving improvement – 90% of practices that we have re-inspected have improved since last October. Through their hard work and dedication, practices are making positive changes to the care they deliver.’

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