Controversial CQC tool will continue to 'stratify' GP practice risk

GP practices will continue to be 'stratified for risk' when the CQC republishes its intelligent monitoring system from the end of June.

CQC ratings: intelligent monitoring tool revamp underway
CQC ratings: intelligent monitoring tool revamp underway

The watchdog scrapped the ‘risk-band’ system behind its intelligent monitoring tool last month, after data published via the tool led to claims that one in six GP practices were failing despite few having been inspected.

The CQC conceded that it needed to change the way it analysed the information, and drop language that implied patients were being put at risk.

But CQC officials have now confirmed the intelligent monitoring system will continue to be made publicly available, despite admitting that the quality of underlying data ‘is not as good as we would like it to be’.

GP regulation

Paul Bate, CQC director of strategy and intelligence, said the watchdog would continue to become ‘more information- and data-driven’ and use data ‘alongside inspections’, as part of its regulatory approach.

The statements came at a CQC board meeting last week where the results of an internal review into the GP intelligent monitoring system were presented to CQC board members.

GPC deputy chairman Dr Richard Vautrey warned that assessments of practices should be based solely on inspections, where the ‘local context’ of practices can be taken into account. The CQC would need to be ‘really cautious’ focusing more on data, he said.

He added: ‘There is real a concern that they're using information in ways it wasn’t intended to be used. I think that any information they release has to be heavily caveated so that those who look at it don’t come to the wrong conclusions.’

GP monitoring errors

The review into intelligent monitoring – along with an internal audit – was instigated last December after the watchdog admitted it had made errors in the way it calculated its indicators.

But the CQC confirmed it intends to publish a ‘refresh’ of intelligent monitoring in June and will continue to republish it ‘roughly every five months’ thereafter.

CQC director of intelligence Emma Rourke said: ‘We will continue to risk stratify but not as a summative band. We will continue, as part of our development of GP intelligent monitoring, to consider the right way that we can ensure that the data flows through to supporting inspections, making sure our analysis has maximum impact as well as integrity.’

Throughout the meeting, CQC chairman David Prior expressed doubts about whether data available for general practice was ‘robust enough’ to be used as part of an intelligent monitoring system.

Mr Bate disagreed with this, but admitted the data available for general practice was not ideal for use in assessing GP practices.

He said: ‘There are some good data sets - the GP-patient dataset is good data […], QOF and prescribing data is also important, but – and it’s a big 'but' – it is well-acknowledged that the quality of general practice data isn’t as good as we would like it to be.

‘I think we've got a long way to go with general practice. But I wouldn’t want to imply that we don’t have any good data to inform inspections - we do.’

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