Viewpoint: CQC must not blame underfunded GPs for NHS crisis, says Dr Kailash Chand

Writing for GPonline, BMA deputy chairman Dr Kailash Chand sets out his personal concerns about the impact of CQC plans to place failing practices in 'special measures'.

Dr Kailash Chand: concern over CQC approach (Photo: Michele Jones)
Dr Kailash Chand: concern over CQC approach (Photo: Michele Jones)

This week, CQC chief inspector of primary care Professor Steve Field warned that GP surgeries providing poor or unsafe care would be shut down under a new 'two-strikes-and-you’re-out' policy. He stated that 'if a GP practice is rated inadequate that will be the starting gun to force it to improve fast'.

But will this really be the case, or is it just a way of blaming GPs for a healthcare system that can no longer cope with rising demand and diminishing resources?

GPs care passionately about their patients and are dedicated to providing the best possible standard of treatment. Patient safety and care is every GP's main priority, and the overwhelming majority of the 8,000 GP practices across England provide an excellent service to the nearly 1m patients who walk through their surgery doors on a daily basis.

Investment is vital

To continue achieving this however, general practice desperately needs sustainable investment and resources.

It is important not to create a counterproductive blame culture based on isolated examples, which could wrongly damage patient trust in wider GP services. Where there are issues, we need to understand the reasons for any shortcomings and work to resolve them.

General practice is close to breaking point, and GPs are increasingly frustrated by the rising number of constraints which are impacting on services and undermining our ability to do our best for those who need us. There are huge disparities between practices in terms of basic funding - some practices receive £70 per patient per year and others anything from £120 to £200 per patient per year.

Many GP practice buildings are in a state of real decline with four out of 10 GPs saying that their premises are so cramped and inadequate they are struggling to deliver basic GP services. Some are struggling to recruit, as fewer junior doctors are training to be GPs yet more senior GPs are retiring early or moving abroad for work.

Serious threat to services

This situation is deeply concerning and represents a serious threat to the delivery of effective GP services to patients. There will be too few GPs to meet the needs of our patients, resulting in increasing delays for patients to get appointments.

We desperately need more GPs, more practice staff, and more nurses to meet demand and provide the care our patients deserve.

'Two-strikes-and-you’re-out' is not the way to solve these long-term problems. We need the government to commit to long-term, sustained investment in general practice that addresses the fundamental challenges facing GP services. The last thing we want is for GP practices to close when what patients need is high quality, local services.

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