Exclusive: CQC outstanding GP practices paid 32% more than those rated inadequate

The average practice rated outstanding by the CQC is paid a third more per patient than the average 'inadequate' practice, analysis of the majority of practices in England has revealed.

GPonline analysis of GP practice funding against their CQC rating suggests there is a clear link between performance in inspections and funding.

While inadequate practices receive £128 per patient on average, those rated requires improvement receive £136, ‘good’ practices £145 and 'outstanding' practices £169, the results show.

Comparing top performers against practices with the lowest rating, those rated outstanding tended to receive 32% more funding per patient than inadequate practices.

Inadequate practices are paid almost £15 less per patient than the national average of £142.62 – while outstanding practices receive £26 more.

The GPC said the results laid bare ‘how flawed the CQC rating system is’ with poorly-funded practices penalised under the regime.

GP funding

The results compile ratings from over 6,340 GP practices – the majority of those in England – of which 4% were outstanding, 84% good, 9% requires improvement and 2% inadequate.

GPonline matched CQC data to data published by NHS Digital on the average amount paid to each practice in 2015/16.

There is also a clear correlation between list size and CQC rating, rising from 4,860 for the average inadequate practice, 6,250 for requires improvement, 7,780 for good and 9,380 for outstanding.

As a result, the average total amount in NHS payments made to outstanding practices is over double that of the average inadequate practice, at £1.3m compared to £565,000.

The findings come as the watchdog completed its first round of inspections, meaning every practice that was registered when the Ofsted-style rating scheme began in October 2014 has been visited and assessed by inspectors at least once. Not all of these practices have had their reports and rating released so far.

Map: GP practice CQC ratings

GPs have previously hit out at the CQC for casting judgments that ignore the financial pressures facing practices.

Family Doctor Association chair Dr Peter Swinyard said he had almost closed his practice after narrowly escaping bankruptcy, a factor he claimed was not considered when inspectors rated his practice 'requires improvement'.

The CQC responded by stating it expected practices to meet certain standards ‘irrespective’ of funding.

It added in its recent State of Care report, released in March, that it did not consider being ‘financially efficient’ and ‘providing high-quality care’ as mutually exclusive.

‘Some problems with the quality of care do require new resources, but many do not,’ the report said.

The watchdog has acknowledged in the past that funding is one of several factors ‘strongly’ associated with its ratings.

GPC deputy chairman Dr Richard Vautrey said: ‘These findings provide yet more evidence that if general practice was properly funded practices would be in a better position to respond to the growing needs of their patients.

‘It also shows how flawed the CQC rating system is, with practices being penalised because of wholly inadequate funding levels.’

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