GP practices should join forces to deliver services at scale, says CQC

GPs should consider working with other practices to 'increase the scale of delivery of GP services', the CQC has said in its annual review of health and care services in England.

CQC chief executive David Behan
CQC chief executive David Behan

The report, published this week, called on GPs and other primary care providers to innovate to meet rising demand without waiting to be told to innovate. It said out-of-hours primary care should use technological innovations to improve.

GPs are also told they should be responsive to local needs and the latest issues, which could be anything from ‘cultural acceptance of high levels of diabetes and obesity’ to female genital mutilation.

The CQC began its new inspection regime of GP practices at the beginning of this month, with the first Ofsted-style ratings due to be published within the next few weeks.

Larger practices 'perform better'

Analysing the CQC’s inspection of more than 1,700 GP practices carried out this year and last, the report found that larger practices tended to perform better against the CQC’s five groups of quality standards. There was a 15 percentage point difference between the best and worst performing practices, with those with a list size of more than 15,000 scoring on average 90% against the standards.

Practices with a list of less than 2,500 patients, scored only 81%.

Chairman of the Family Doctor Association, Dr Peter Swinyard, said the CQC was ‘measuring the unmeasurable’.

‘These inspections are designed to assess large organisations,’ he said. ‘Small practices might not have the protocols and the procedures, they just get on with the job. It is fair to say that there probably is a greater variation in quality of care among smaller practices than larger practices, but what is needed is help to improve for those practices that need it, not a system of traffic lights.'

Other recommendations included in the CQC report include a call for GPs and other primary care staff to report poor care.

The report says: ‘If a community nurse sees that a patient had not received a visit by a GP when it was needed, or if an out-of-hours provider cannot access the most up-to-date medical records for a patient, raise this concern so that providers can learn and improve the care they provide.’

And it calls for better co-ordination between providers, including improved information sharing.

The report says: ‘GPs should be aware when one of their patients is seen at A&E or is admitted to hospital; they should know what their condition is, and when they will be discharged. This should not require daily phone calls or faxes.’

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