GPC pushes for lighter CQC approach that could see inspections scrapped

The GPC has urged the CQC to lighten its regulatory burden on GP practices, urging it to scrap inspections altogether as the watchdog revealed it has 'started work' on its future regulation strategy.

Professor Steve Field: CQC has begun review of regulation (Photo: Pete Hill)
Professor Steve Field: CQC has begun review of regulation (Photo: Pete Hill)

GPC deputy chairman Dr Richard Vautrey told GPonline that the CQC must adopt a ‘slimmed down, less bureaucratic, less costly system’, and warned that ‘there was no point’ going round and inspecting all GP practices again once it has rated them all by October next year.

The CQC’s chief inspector of general practice told the Health Service Journal earlier this week that this may be the direction it is heading in, revealing that the watchdog was considering ‘a more light touch’ form of GP regulation.

The move could pave the way for a less confrontational relationship between GP leaders and the CQC. Both the RCGP and the GPC called in June for CQC inspections to be immediately suspended, warning that practices were ‘close to meltdown’.

Inspections so far have revealed an overwhelming 84% of practices have been rated ‘good’ or better, demonstrating that repeating the current intensive inspection regime would not be necessary year-on-year and needlessly costly, Dr Vautrey said.

‘Pointless’ inspections should be cut from the CQC’s regulatory process, and it should instead look at widely available data on practices to flag up concerns.

Scrap CQC inspections

‘I think it’s perfectly possible for the CQC, NHS England and others to use the data that is widely available across the NHS to satisfy themselves that practices are delivering on their expectations for patients and on their contracts,’ he said.

‘There's often very little need for them to do much more than that. If there are clear alarm bells ringing for an individual practice, then those with an interest in the area will want to satisfy themselves to the reasons why there's a particular concern – but that really is the exception to the rule.

‘The important thing is to understand the local context – so NHS England or CQC shouldn’t be making judgements simply based on the data, but they will then need to ask some further questions. And often, that will provide the answers for why a particular practice might be different from their neighbours, because of their particular demographic profile or the particular types of patients they have.’

Any practices where concerns are raised – which cannot be easily explained by the practice’s circumstances or local population – should be dealt with how they were prior to the CQC being established, he said.

Map: CQC GP ratings

‘Historically, if there was concern in a local health community about a particular provider – whether that be hospital care ward, a care home or a practice – then the local health body would come in and ask them some questions to find out about the detail.

‘And that’s what should [still] happen. We should be trusting the vast majority of good professionals to get on and do that job without burdening them with extra work.’

Dr Vautrey said it was clear that the profession had no confidence in CQC. ‘There needs to be a real re-think about the benefits of the current system and moving towards a much more lighter system that recognises the vast majority of practices are "good" or "outstanding".’

A CQC spokesman said: ‘We have started work on our strategy for the next five years looking at how we regulate health and social care services in England. That work will look at a whole range of options for the future of regulation, including whether there is a role for CQC to report on the quality of care across local areas as well as how we prioritise our inspection activities.

'We will carry out a full consultation on these options early next year.’

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