CQC outlines plan to address concerns over GP ratings ethnicity bias

The CQC will assess testimony from GPs from ethnic minority backgrounds along with evidence from its own data and other organisations under plans to address concerns over ethnicity bias in its ratings.

CQC chief inspector of primary care Dr Rosie Benneyworth

Over the next few months, the regulator - which is reforming its inspection strategy - has announced it will carry out work to investigate concerns that GPs from ethnic minority backgrounds may receive 'poorer CQC ratings or regulatory outcomes'.

The CQC plans to review the impact of its current regulatory approach, looking at evidence it has collected as well as running surveys and focus groups. It will also examine its own diversity and methodology ‘through an equality lens’.

The announcement comes two months after the watchdog rejected calls for an independent review of its ratings process to look for potential bias against GPs from black, Asian or minority ethnic (BAME) backgrounds.

BAME practitioners 

In 2019, the GMC's 'Fair to Refer' report highlighted concerns that BAME GP partners may be more likely to receive lower ratings following CQC inspections. GPonline has also reported on GPs' accounts of their experiences during inspections, including one claim that an inspector had made racist comments.

CQC primary care chief inspector Dr Rosie Benneyworth said in an update to GPs that work would start soon to address concerns around bias against GPs from ethnic minorities - and that it would feed directly into its future strategy for primary care regulation.

She said: ‘One of the challenges my team and I have been reflecting on, is concerns that practices led by GPs from an ethnic minority background receive poorer CQC ratings or regulatory outcomes.

‘Over the next few months, we will be carrying out work to understand this issue and the impact of our current regulatory approach. This will include looking at evidence we and other organisations hold, previous research and listening to the experiences of GPs from an ethnic minority background, including through surveys and focus groups. We will also be examining our own diversity and methodology through an equality lens.

CQC inspections

‘We will also be looking at other factors that may have an impact, including deprivation, the demographics of a local area and how the wider health and social care system works in partnership. This work will help us understand what impacts and influences regulatory outcomes.

‘The findings of this work will directly feed into the implementation of our new strategy and will help us shape what the regulatory approach for primary care looks like in the future.’

Dr Benneyworth added that the CQC was being supported by an expert advisory group made up of organisations that represent GPs from ethnic minority backgrounds, and those working in ‘areas with significant challenges’.

In May, the CQC published a strategy for improving the quality of patient care, including less emphasis on ‘a set schedule of inspections’ and favouring a ‘more flexible, targeted approach’.

GP wellbeing

RCGP leaders voted earlier this year to demand an independent review after the CQC said it planned to investigate 'longstanding concerns' that GP practices with BAME partners may receive lower ratings.

The college's council called on the CQC to 'commission an independent review of inspections of GP practices rated 'requires improvement' or 'inadequate' over the past five years - including those practices which have been closed down due to CQC regulations - to assess if there is an association between the outcomes of inspections and ethnicity or country of qualification of the GP partners'.

In March, dozens of GPs called for an investigation into the CQC's approach to practice inspections, arguing that current methods used by the watchdog had created a 'culture of fear’.

The CQC has said previously that unprofessional behaviour or discrimination of any kind is unacceptable - and that it works closely with providers to ensure its inspection process works for inspectors, staff and patients.

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