CQC inspections cut time with patients and leave GPs more likely to quit, says BMA poll

CQC inspections have cut practices' time with patients and driven up stress and costs, with three quarters of GPs more likely to quit since the regime took effect, a BMA poll shows.

CQC inspection: GPs say time with patients is affected
CQC inspection: GPs say time with patients is affected

A BMA poll of 1,900 GP practices ahead of the 30 January special LMCs conference to debate the crisis facing general practice found that eight out of 10 practices said preparing for CQC inspections reduced time for patient care.

The findings come as LMCs prepare to vote at the crisis conference in London on Saturday on proposals for the profession to refuse to co-operate with CQC inspections. GP leaders have already called for the suspension of the inspection regime, and for the resignation of CQC chief inspector of general practice Professor Steve Field over comments about underperforming practices.

The CQC, however, says it will make 'no apology for acting in the best interests of patients'.

Special LMCs conference: full coverage

Key findings from the BMA poll of GP practices include:

  • 80% said preparing for a CQC inspection resulted in a reduction in time available to care for patients.
  • 70% had to spend funding on staff overtime while preparing for the inspections, and 30% had to employ locums.
  • 87% said that on the day of the CQC inspection staff had to reduce GP services available for patients, with 67% reporting a loss of nursing time.
  • 75% reported that staff suffered from significantly increased stress in preparing for and undergoing inspections.
  • 74% felt the inspection regime could make them more likely to leave general practice.
  • 11% regarded their final CQC rating as a fair assessment.

GPC chairman Dr Chaand Nagpaul said: 'This survey demonstrates the damaging, negative impact that the CQC’s failing inspection programme is having on patient care in general practice. GPs are being forced to divert valuable time away from treating patients towards the endless box ticking, paperwork and bureaucracy that is the hall mark of this programme.

'Vital NHS resources are being wasted on employing locums and staff to cover the work of a GP practice in the run up to and while the CQC is in the building. These findings come at a time when the CQC is proposing unacceptable and extortionate rises in their fees which will pull even more resources away from frontline services.

Map: CQC GP ratings

'GP services must be properly assessed so that the public can be reassured they are getting safe, effective care, which the CQC’s evidence shows the vast majority of GP practices currently deliver.

'However, the current system is disproportionate, onerous and flawed. It is unacceptable that precious resources and time is being taken away from patient care when general practice is under unprecedented pressure from soaring patient demand, falling resources, staff shortages and unresourced work being moved from hospitals into the community.

'As motions at tomorrow’s special conference of GPs make clear, the current CQC inspection regime is not fit for purpose, and needs wholesale reform that produces an effective, slimmed down process focusing on ensuring a safe, effective service for patients.'

A CQC spokeswoman said: 'We make no apology for acting in the best interests of patients, who tell us they want to know care services are safe, effective and responsive.

‘Not only do patients value our inspections, but GPs themselves have told us inspection has helped drive improvement (nearly two thirds of those surveyed). We’ve also found over three quarters (76%) of GP practices and out-of-hours services agreed their inspection provided a thorough review of whether they were safe, effective, caring, responsive and well led.

‘We’ve worked hard to ensure that the inspection of GP surgeries does not impact adversely on the practice being able to provide patient care by working with practice staff to design the agenda for that day. The feedback we’ve received indicates that surgeries already performing well do not find the preparation for inspection arduous, as the BMA suggests.'

The CQC is currently consulting on an overhaul of its inspection regime to fit new models of care.

A GPonline investigation this week revealed that three quarters of GP practices that receive a poor rating after an initial inspection improve within six months.

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