GP leaders demand radical overhaul of CQC process after COVID-19 pandemic

The RCGP and BMA have called for a major rethink on CQC inspections after the coronavirus pandemic - pointing out that reduced regulation during the outbreak has made general practice 'doable' again.

RCGP chair Professor Martin Marshall (Photo: Pete Hill)
RCGP chair Professor Martin Marshall (Photo: Pete Hill)

The watchdog announced this week that it was gearing up to restart inspections as the first wave of the pandemic subsides - with checks on higher-risk providers starting over the summer and lower-risk providers to follow in autumn.

But GP leaders have warned that simply returning to the pre-pandemic inspection regime would be wrong - and that a revamped system based on higher trust is needed.

GPs have for years criticised the CQC's approach to inspection, calling repeatedly for the process to be scrapped entirely or reformed. GP leaders have argued that with 95% of practices rated good or outstanding, inspections at short notice that have a major impact on practice workload cannot be justified.

COVID-19 pandemic

With inspections paused during the outbreak - along with other regulatory processes including revalidation - both the BMA and RCGP have said a return to business as usual after the pandemic subsides would be a mistake.

RCGP chair Professor Martin Marshall said: 'The COVID-19 pandemic has been challenging for GPs and patients, but there are also lessons to be learned from how we have changed the way we work in general practice.

'We have demonstrated that GPs and our teams can be trusted to deliver high-quality, safe patient care, without having to tick as many boxes to prove it. The reduction in regulatory burden since the start of lockdown has freed up our time to deliver safe patient care – and it has made many GPs report that the job has become "doable" again.

'We recognise that there is a place for regulation, particularly to identify practices that are struggling and need support to deliver safe patient care. But with more than 95% of practices rated good or outstanding, the college would advocate a shift away from a pre-pandemic inspection process that many GPs found arduous, stressful and diverted attention away from patient care.

CQC inspections

'We would like to see policy makers trust GPs and our teams to do our best for patients – and give us the time to do so – by replacing a focus on tick-box accountability with one of trust and proportionality. The college will be publishing recommendations around how the regulatory burden on GPs can be reduced while maintaining patient safety in coming weeks.'

BMA GP committee chair Dr Richard Vautrey has made a similar call for the pandemic to bring a complete rethink on inspections. He said the reduction in bureaucracy since the start of lockdown had given practices 'the space to innovate and dedicate more time to patients'.

The Leeds GP said: 'GPC has long called for an overhaul of inspection processes, and now is the precise time for that as we all reflect on learning from this crisis.'

CQC chief inspector of primary care Dr Rosie Benneyworth said: 'As we look to the future of regulation and what we can learn from both the pre-COVID-19 approach to regulation - which was developed in conversation with the profession and people who use services - and the approach taken during the pandemic, we are pleased that the RCGP and BMA are actively seeking to work with us on our future approach to regulation.

'COVID-19 has resulted in fundamental changes to the way that care is delivered, and, just as many providers will be working in new ways, we will need to be more flexible and responsive in the way we regulate.

'We do, and always will speak up for people who use services – everyone deserves to get good, safe care and we’ll take action to ensure this where necessary. We also recognise that services have been operating under enormous strain during the pandemic, and that the important work to reshape services and work across sectors that now needs to happen will also be challenging. We look forward to working with providers across all sector to ensure our regulation can support them to provide the best possible care for people.'

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