Exclusive: London practices face highest risk of poor CQC rating

GP practices in London are more than twice as likely to be rated 'requires improvement' or 'inadequate' as their counterparts in the north of England, analysis of GP ratings shows.

CQC inspection (Photo: JH Lancy)
CQC inspection (Photo: JH Lancy)

London has the highest rate of poor CQC ratings in the country, with almost one in five (18%) rated ‘requires improvement’ and 5% ‘inadequate’ to date, analysis of thousands of reports has revealed.

This means almost a quarter of practices (23%) in the capital have received one of the bottom two ratings, compared to just 13% in the south of England and 16% in the Midlands and east of England.

Among practices in the north of England only 10% received one of the bottom two ratings  nine out of 10 achieved ‘good’ or ‘outstanding’ scores.

The Midlands and east of England has the highest proportion of outstanding practices of any region, coming in at 5%. The north and south of England have 4%, while London comes in at 2%.

Leading London GPs warned that the capital's CQC performance was likely the result of 'extreme' chronic underfunding over many years, which has left practices across the region struggling to cope. Londonwide LMCs declared a state of emergency earlier this year.

The latest figures take account of the current ratings held by over half of all practices in England – over 3,860 – after the CQC released enough reports to pass this threshold earlier this week.

Regionally, 53% of practices in the north of England and 38% of practices in the capital have been rated so far, meaning the discrepancy could be set to change as more CQC reports are released.

Map: CQC GP ratings

But the variation has persisted since at least a year ago, when GPonline first reported that a quarter of London practices were rated 'requires improvement' or 'inadequate'.

The picture in London differs from the national average, in which 86% have been rated good or outstanding, 11% requires improvement and 4% inadequate.

The watchdog has committed to inspecting all remaining practices within the next 10 months to finish in time for its deadline of 31 March 2017.

Practices rated requires improvement or inadequate are regularly revisited by inspectors, receiving a follow-up within at least six months.

London 'catastrophe'

Londonwide LMCs medical director, Dr Tony Grewal, said: ‘This mirrors our subjective experience, that there are lots of practices in London struggling. And a struggling practice is not one that is going to be able to bring itself up to scratch quickly and easily.

‘These things take time and support and investment and that’s been sadly lacking over many years, and now we’re seeing the results.

‘The support, development, the investment and all the things that general practice has needed over the last 10 years have been lacking in the extreme in London.

‘General practice has been undernourished chronically in every possible for such a long time that – although we need a quick fix immediately because general practice is in crisis in London – we also need medium- and long-term plans. Those plans need to deal with premises, workforce and morale. And it’s going to cost money.

‘Until that money is identified and invested without all the ridiculous strings which are attached to so many NHS initiatives, then I'm afraid we’re staring at catastrophe.’

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