Days of single-handed GPs are over, says CQC chief inspector

The days of working as a single-handed GP in isolation 'are now over', the CQC's chief inspector of primary care has told GPs.

Professor Steve Field, CQC chief inspector of general practice

Speaking at the Best Practice conference in Birmingham last week, Professor Steve Field – who oversees the ratings of all GP practices – said he believes practices must work together in larger groups or as part of professional teams to deliver good or outstanding care.

It follows on from the CQC’s recent State of Care report, which contained research showing a direct correlation between ratings and practice list size and a suggestion from CQC bosses that practices in federations tend to score higher.

He said: ‘We know that demand is increasing with an ageing population and the complexity and we know we have fewer GPs.

‘In order to survive to grow and prosper – and I still believe that being a GP is the best career you can possibly have – we need to work in multiple professional teams, we need to work in larger groups of practices. The days where you work in splendid isolation as a single-hander are now over.

‘We are seeing outstanding practices which are single-handers, but they work increasingly linked to other practices. So when we see outstanding practice, there are more inadequate practices that are small than there are outstanding practices, but the ones that are outstanding were in either loose networks or are now part of bigger groups.’

Local leadership

Professor Field praised the performance of practices in inspections, but warned the CQC had uncovered ‘pockets of poor care’ around the country – singling out central London, Birmingham and Thurrock in Essex.

Strong leadership ‘makes the difference’ and overhauls care, he said, citing central London CCG area Tower Hamlets for its ‘brilliant leadership team’ and high-quality care.

‘You don’t need a regulator if GPs leaders locally and the system do their job properly, and I would assert that we haven’t done that,’ he told delegates. ‘And we are all culpable, including myself.

‘If you think about it, we've failed as a profession if we haven’t worked with practices and identified [poor practice] internally and across our CCGs before inspectors go anywhere near it.’

He went on to add that practices overall have outperformed other providers including hospitals and social care.

‘The story for us – that’s most of you in here [at Best Practice] who work in general practice – is that we as GPs are doing really good work,’ he said.

‘We’re serving the population of this country really well, and we should be proud that general practice is doing so well. Unfortunately, there are a small proportion of practices that are providing either no care or completely inadequate care. We have to make sure that improves.’

The CQC has completed over 5,500 inspections so far, and is projected to have done at least 8,000 by January, ahead of its deadline to get through all practices by the end of March.

Late last year the BMA demanded the resignation of Professor Field after the GPC backed a no confidence vote in the CQC chief inspector.

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