GP regulation should be merged into 'one process', GPC says

GP regulation should be slimmed down to tackle overregulation so that there is 'one process and one dataset that is acceptable to all regulators', the GPC chair has warned.

The comments come as a GPonline poll of 440 GPs found that two in five (39%) said there was too much overlap between revalidation and CQC processes. This figure rose to 46% among the 193 GP partners who took part in the poll.

A quarter (24%) of all GP respondents said they did not think there was much overlap between the two and a further 37% said they were not sure.

GPC chair Dr Richard Vautrey said GPs were overregulated 'with far too heavy a burden' that was counterproductive to patient care.

Although the CQC regulates the provider as a whole and revalidation assesses the fitness to practise of individuals, many GPs said they felt that both schemes often lead to duplication of effort.

One GP respondent to the poll said: ‘It feels like a battering when you are working beyond capacity to be asked over and over again what are you going to do about improving access when standing still is hard enough.’

Another described the combined impact of revalidation and CQC as ‘strangulation by regulation’.

‘It will lead to increased burnout and increased early retirement,’ the GP added. ‘There is absolutely no focus on the wellbeing of doctors who are the backbone of the service.’

GP regulation

Some respondents said that aspects that should fall under the domain of one were bleeding over into the other.

One said: ‘At my CQC inspection I was quizzed about my ability to be an up-to-date clinician. I felt this inappropriate as this is what appraisal is for and no reflection on the practice as a whole.’

It follows other findings on regulation from the GPonline survey, which revealed that half of GPs do not think changes driven by CQC inspections have improved care and that two thirds say revalidation has not benefited their clinical practice.

One GP said: ‘In this period of work-related stress and burnout, the GMC and CQC should be equally made responsible to get things streamlined to help us doctors, otherwise, I am afraid to say it will be too late.’

The CQC said it is working alongside the GMC to help ‘reduce duplication and the burden on providers’ as part of its plans to overhaul its GP inspection over the next year.

Its new scheme will see practices take a more leading role in their own regulation, by sending information yearly to the CQC in lieu of annual inspections. However, yesterday the RCGP warneed that the new process would put an extra administrative burden on practices.

Reducing the burden on GPs

Dr Vautrey said: ‘GPs are overregulated with far too heavy a burden which takes them away from patients. It’s effectively counter-productive in doing do so. There’s NHS England, GMC revalidation, CQC and local CCGs – which are all in many ways doing the same thing.

‘We need to find a way of slimming down the system considerably, so that’s there one process and one dataset which is acceptable to all regulators, and they don’t add more and more burden onto GP practices.

‘There's absolutely no point the CQC asking for all sorts of information and the GMC asking for it again in a slightly different way.’

Chief inspector Professor Steve Field said in a letter to practices on Wednesday: ‘We are working with the GMC, NHS England and other regulators to streamline these requests, avoid duplication and share information. We will continue to work with organisations representing GPs to develop this process.’

GMC chief executive Charlie Massey said: ‘We continue to work closely with CQC and the RCGP to reduce any unnecessary duplication between our requirements and those of the CQC.

‘We recently unveiled a raft of commitments to further improve revalidation including reducing burdens and improving the appraisal experience for all doctors.’

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