First 1,000 CQC visits find 10 practices with 'serious failings'

Around one in 100 GP practices in England have 'serious failings' and could be forced to close, the CQC has warned.

CQC: inspection overhaul
CQC: inspection overhaul

The watchdog outlined changes to its approach to primary care inspections under chief inspector of general practice Professor Steve Field on Wednesday.

From April 2014, a quarter of GP practices in each CCG area will face inspection every six months. Overhauled CQC inspection teams will include a GP, a practice nurse or practice manager and a trainee GP, as well as a CQC inspector.

A total of 910 GP practices have been inspected by the CQC since April this year. Inspectors have concentrated on practices that registered as non-compliant and have carried out 90 follow-up inspections to check that improvements have been made.

Launching his GP inspection blueprint, A Fresh start for the regulation and inspection of GP practices and GP out-of-hours services, CQC chief inspector of general practice Professor Steve Field said most practices inspected were good but 10 had serious failings and had received warnings.

A total of 34% of practices inspected failed in at least one of the CQC's 16 standards.

Practices with serious failings were found to have problems including maggots in treatment rooms, out-of-date oxygen cylinders and no temperature monitoring on vaccine fridges.

Two GPs in one practice referred each other to the GMC for ‘incompetence’, Professor Field said. ‘NHS England took action and both GPs are no longer working there.'

Professor Field ruled out routine unannounced inspections. ‘This is not about witch hunts,’ he said. ‘We are not looking for perfection. There is no single perfect practice in this country.’

Every GP practice is due to be inspected by 2016. GP out-of-hours services will be inspected from January.

One LMC has warned that CQC inspections have reduced some GPs and practice staff to tears.

RCGP chairwoman Dr Maureen Baker said that GPs’ high workload is risking patient safety. ‘Many GPs are now routinely working 11-hour days and conducting up to 60 patient consultations in a single day,’ she said.

‘Half of GPs believe they can no longer deliver safe patient care due to increasing pressures and unsustainable workloads.

‘It's crucial that any inspection of GP practices should have input from people who have direct experience of frontline general practice and who know first-hand about the challenges that GPs and their teams are facing in trying to deliver quality care for patients. But we must make sure that GPs, practice nurses and practice managers are not taken away from the day job of providing care to patients as a result of their involvement in inspections.

‘Breaches of procedure cannot be condoned - even if they are isolated incidents - but the inspections were largely targeted at particular practices which had already been identified as having problems. Specific areas for improvement have been found and the CQC must now work with these practices to ensure that they meet the necessary standards and that other practices can learn from their experiences.

‘Vaccine storage and cleanliness are two very important priorities for every practice and the low rates of vaccine-preventable disease should reassure patients that there is no widespread breach of "cold chain" storage for medicines.’

GPC chairman Dr Chaand Nagpaul said: 'It is encouraging that the CQC recognises the high standards of care provided by the vast majority of GP surgeries it has already inspected.

'While most patients receive high quality care from their GP, we need to understand where and why shortcomings in a small number of practices exist, and the BMA is committed to working with the chief inspector to improve standards.

'It’s important, however, that anecdotes of poor practice are not be used to distort the reality which is that the overwhelming majority of hard-working GPs provide high quality care which is appreciated by patients.'

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