CQC U-turn on practice risk scores after GP fury

The CQC has performed a dramatic U-turn on its practice risk rating system that led to 1,200 GP practices in England being labelled as 'failing' in national media.

CQC chief inspector of general practice Professor Steve Field
CQC chief inspector of general practice Professor Steve Field

The CQC revealed on its website that it has altered how it assesses patient survey data as part of its 'intelligent monitoring' tool. The change will mean that 60 practices previously rated in the two highest-risk categories (band 1 or band 2) by the CQC will move into lower-risk categories.

A total of seven practices, however, will now move into higher categories of risk. The change comes just three weeks after the CQC published its monitoring tool.

GP magazine revealed on Friday that a leading primary care solicitor believes practices labelled 'high risk' may be able to take legal action if they are later found to be 'good' or 'outstanding' following a CQC inspection.

One in three GPs responding to a GP magazine poll said the watchdog should financially compensate practices in this scenario, and the vast majority called for written apologies or letters to explain the situation to patients from the CQC.

Poll: should Professor Steve Field resign?

BMA deputy chairman Dr Richard Vautrey said: 'The need for these changes by CQC has demonstrated how badly they've failed on this and how they should have listened to our warning before they published the first data set.

'Tinkering with a fundamentally flawed system will not help to restore the reputation of the many good GPs and practices who have already been unfairly named and shamed. Instead they should do what we called on them to do in the first place and remove the banding system altogether and wait until inspections have been done before making any public judgements on the quality of GP practices. They should also apologise to badly let down practices and needlessly worried patients.'

Explaining the overhaul, CQC senior national GP adviser Professor Nigel Sparrow wrote on the watchdog’s website: ‘Following feedback from national and local stakeholders, and working with NHS England, we have now completed a comprehensive review of the data and, as a result, there are a number of changes.’

CQC apology

Most practices would not be affected by the rethink, he said, but those that were would be contacted. The CQC will apologise to practices whose rating is being lowered ‘for any concern this may have caused GPs, their staff and their patients’.

He admitted that the CQC is ‘clear that some aspects of GP practice activity do not lend themselves well to the use of metrics’.

Professor Sparrow added: ‘I would like to take this opportunity to reinforce the message that the banding is not a judgment. Intelligent monitoring helps us to prioritise our inspection programme as well as informing the questions we will ask during the inspection. Intelligent monitoring will never be used in isolation to make a final judgment or produce a rating of a GP practice.'

A CQC spokeswoman said: 'Feedback and further analysis showed that one of the indicators on patient access did not always measure the patients’ failure to get an appointment, so we have agreed to redesign the indicator. This did not emerge during our consultation and testing with 400 practices, but we accept that further work is required. Data for other indicators was updated by NHS England.'

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