Dr Hendrik Beerstecher, who runs the 111 Canterbury Road surgery in Kent, is disputing a number of issues raised by inspectors after a visit to his practice in March this year.
The practice was found to be inadequate overall – with inadequate ratings for the 'safety' and 'well-led' categories, requires improvement ratings for 'effective' and 'responsive' categories and good for 'caring' - and must improve within six months to avoid being shut down.
But the Kent GP - whose practice has an above-average patient satisfaction rating, with 86% of patients saying their experience of the surgery is good overall and that they would recommend it to others - has hit back at the findings.
Map: GP CQC ratings across England
Dr Beerstecher has now published video and audio recordings of the inspection on his practice website - along with further details of correspondence with the CQC - ‘to allow people to judge for themselves’ whether the watchdog had made inaccurate judgments about his practice.
The CQC has condemned his decision to make and publish the covert recordings, complaining that its staff feel this was an 'unfair intrusion on their privacy'.
Dr Beerstecher has said he felt the recording was a 'sad necessity after numerous bad experiences with various NHS authorities in the last five years'.
His decision to record the inspection comes after GPC member Dr Paul Cundy recommended last year that GPs should consider recording inspections to ensure they have evidence to back up any complaints about the process – although he did not suggest this should be done covertly.
Dr Beerstecher's fight against his inadequate rating began after the CQC sent him a first draft of its report rating his practice. He responded with a 70-page list detailing alleged inaccuracies - some of which he claims are backed up by the secret recordings.
GP opening hours
He argued that some points raised by the CQC were ‘plainly untrue’ – such as opening hours not being displayed – while others were unreasonable, such as no female GP being available at the single-handed practice.
The CQC accepted some of these points, but rejected many more, upholding the decision to rate the practice inadequate and placing it in special measures.
Dr Beerstecher contends that the CQC came to inspect the practice ‘with an agenda’ to close it down, after its report revealed NHS England had formally expressed concerns about the practice ahead of its inspection, claiming he was ‘in direct opposition to current health policy’.
The CQC has written to Dr Beerstecher asking him to remove the recordings of his inspection from his practice website. The letter said the covert nature of the recording and publication online ‘has unfortunately led our colleagues to feel a sense of intrusion and distress’ and may contain sensitive information on patients – although patient names were removed from the published version.
The CQC warned: ‘While we have no issue with the conduct of our colleagues shown in the video and audio recordings, we consider that recording them without their knowledge and publishing those recordings was an unfair intrusion on their privacy and, along with the publication of potentially patient-identifiable information in the audio recordings, is likely to be inconsistent with your statutory responsibilities under the first Principle of the Data Protection Act 1998.’
CCG adds to pressure
The practice’s CCG has also written to Dr Beerstecher as a result of the CQC rating, detailing a number of improvements the practice must make to avoid closure. Dr Beerstecher says these are not contractual requirements, and has contacted his LMC for support.
Under CQC requirements, the practice has six months from publication of its report until April 2017 to make improvements and avoid being closed down. But the CCG has said it could terminate the practice’s contract earlier than this unless the raft of improvements are made.
Dr Beerstecher said: ‘Other practices with similar or worse shortfalls have been passed as "good". No one is perfect, but I believe we were targeted and the inspection team was biased before the visit by additional information. There is a lack of consistency in the CQC inspections and ratings.’
A CQC spokesman said: ‘We would expect anyone wishing to make a recording to ask the permission of the individuals involved, as a matter of courtesy. It is disappointing that this was not done in this case and that recordings were published online without informing the individuals.’
GPC deputy chairman Dr Richard Vautrey did not comment on the specific case, but advised it was best to be ‘transparent and open’ when deciding on whether to make recordings in any interaction.
Practices ‘should involve their LMC’ for advice on the most appropriate action to take if they disagree with their CQC rating, he added.