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Challenging the CQC – advice for GP practices

Solicitor Nythan Smith from law firm Ridouts explains how practices should go about challenging CQC decisions or responding to communications from the regulator.

Nythan Smith, Solicitor, Ridouts
Nythan Smith, Solicitor, Ridouts

Challenging the CQC can be a daunting prospect for GP practices, especially given that GPs and their practice managers are so busy. Interactions with the CQC can be laborious and require focus to address and respond to the plethora of enforcement action the regulator has at its disposal.

However, it is important that practices do challenge where there are grounds to do so, as a failure to do this could have a material impact on the future of the practice.

The CQC’s model of regulation is in the process of transitioning so that the focus is more on those services that pose a greater risk.

GP practice ratings

As a sector, GP practices receive the greatest proportion of good or outstanding ratings out of all service types regulated by the CQC. 95% of practices are rated good or outstanding.

Only 5% of all practices receive ratings of requires improvement and inadequate. Some may interpret this as positive for the sector as a whole, with the best quality outcomes being received by GPs’ patients.

However, the fact that the regulator has rated the majority of providers favourably also means that those 5% of providers are likely to be in receipt of more targeted and intense action. It is also important to remember that the history of ratings awarded does not necessarily result in the same being awarded in the future, and any provider can fall foul of an inspection at any given time.

Enforcement action

There is a risk that some GPs, having not been in receipt of enforcement action, believe that it could not happen to them. They may think all that is required is to cooperate with the CQC and peer support groups (in the case of those providers in special measures) to demonstrate improvement to dissuade the CQC from taking more action.

But, if the CQC is incorrect in its assertions about your practice it is vital that the record is set straight in responding to regulator to avoid overly onerous actions, which take the practice away from its core purpose – the provision of good services to patients.

Given the intense pressures on GP practices they may not necessarily retain the capacity to properly engage with the CQC in responding to their inspections and other communications.

Lawyers such as Ridouts can help GP practices who are faced with concerns raised by CQC. It is helpful to have a critical friend such as ourselves who can interrogate the evidence which is being relied upon and stand up to CQC in a measured and proportionate manner.

Our experience gained in supporting GP practices will ensure that responses are properly triangulated and targeted to combat CQC’s version of events.

Challenging the CQC

There are a few points to remember when challenging CQC. If challenging an inspection report the relevant time is at the point of the inspection, so consider the comments made within the draft inspection report and compare it as against the evidence you hold at the time of the inspection.

You can of course update CQC with actions taken since the inspection but that is unlikely to impact on the ratings awarded.

If you are challenging a notice of proposal, or decision to place conditions on or suspend or cancel your registration, the relevant point is not that at the time of the inspection on which the evidence to the respective notice relies, but at the point of the submission of your representations.

Consequently, even if you accept the position at the point of the inspection if you can demonstrate that the concerns have been addressed and there is a clearly thought through plan to prevent reoccurrence, then that is likely to stand you in the best stead to successfully challenging the CQC.

  • If you receive correspondence from CQC and require advice in relation to responding and challenging other CQC enforcement action, you can contact Ridouts Professional Services Ltd at info@ridout-law.com or by calling 0207 317 0340.

Ridouts Professional Services PLC

Ridouts is a law firm that only acts for care providers. We provide legal, operational and strategic advice when providers are faced with matters that could negatively impact their businesses, such as poor CQC inspections and enforcement action. www.ridout-law.com

This article is funded by Ridouts for GP Connect

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