CQC puts smaller and underfunded practices at 'great disadvantage', says GP leader

The chair of the Family Doctors Association (FDA) has hit out at the CQC, accusing the watchdog of being unfair to small practices and casting judgments that ignore the financial pressures facing practices.

Family Doctor Association chair Dr Peter Swinyard (Photo: JH Lancy)
Family Doctor Association chair Dr Peter Swinyard (Photo: JH Lancy)

FDA chair Dr Peter Swinyard – partner at the Phoenix Surgery in Swindon – hit back after receiving a ‘requires improvement’ rating from the CQC.

He argued that the CQC does not take into account the difficulties facing a practice, which puts those that are poorly-funded and have smaller list sizes at a disadvantage.

But the CQC told GPonline it has a duty to ensure practices meet certain standards ‘irrespective of size or funding’.

Dr Swinyard's practice caters for 4,600 patients and employs two part-time salaried GPs. Its CQC rating comes after the practice fought back from financial problems that almost pushed it to closure last year.

The practice was rated 'good' for being caring and responsive, and 'requires improvement' for safety, effective and well-led.

Map: CQC GP ratings

Inspectors said it must improve its fire safety processes, ensure policies are accessible to staff and that processes are in place to replace soft furnishings in its waiting room.

Dr Swinyard said the criticism focused too much on box-ticking exercises. The practice has no full-time practice manager, instead relying on a locum supplied by NHS England one day a week.

As a result, Dr Swinyard says that he must take time out from patient care himself to tackle admin issues.

He said the rating came as a ‘complete slap in the face’ to staff after they had worked to bring the practice back into solvency from the brink of closure last year. The practice formally disputed the rating, but the CQC did not change its judgement.

The practice began experiencing financial problems in early 2016, Dr Swinyard told GPonline.

‘I've managed to turn that around in the last year and a bit with help from my staff,' he said. 'But the CQC take no acknowledgement of that at all – the fact that we could just have closed the doors and gone bankrupt, which we very nearly were.

'We were trading while insolvent. Most of the last year I haven’t taken an income from the practice, because there is no money to take.’

Dr Swinyard has long been a vocal critic of the CQC, previously accusing the watchdog of ‘feasting on the bones of general practice’ after it significantly raised fees and calling for it to be scrapped.

CQC rating

Dr Swinyard said: ‘There is no money in the practice. And when you're in difficulties financially, which we are, they’ll just use it as a jolly good opportunity to have a smack at you.

‘The CQC puts the poorly-funded practices like us at a great disadvantage. I can't afford to employ a manager – I can't even afford to pay myself most months. There is no money in the practice; we can't make it up when there isn't any.

‘And at a time when they say they're trying to support smaller practices and help them survive, it’s just hot air and whiskers – because they have another branch of government which is trying to get us down.’

Ruth Rankine, deputy chief inspector of general practice at the CQC, said: 'Following our internal quality assurance processes, the draft report, with ratings, is sent to the practice to check for factual accuracy. If practices have additional evidence to counter what was found on inspection then we can consider this as part of the factual accuracy process.

‘Irrespective of size or funding, patients have the right to expect safe, effective, caring, responsive and well-led services.’

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