GPs consistently top NHS provider ratings, says CQC

GP practices are more likely than all other NHS providers to receive good or outstanding ratings and significantly less likely to drop down a rating upon reinspection, according to a CQC report that highlights extreme pressure facing the health service.

The CQC’s State of Care report 2017 shows that 93% of GP practices have been rated good or outstanding, compared to 80% of adult social care services, 74% of mental health services and 61% of hospitals.

But the watchdog's chief executive David Behan warned that the health service was operating in the 'toughest climate that most can remember'. He called for greater collaboration between health services, warning that NHS staff could not work any harder.

The annual report follows an earlier CQC report on findings from visiting and rating all GP practices in England, which praised their strong performance in the face of rising pressures.

With 89% of practices rated good and 4% outstanding, some 52m patients have access to good or outstanding care, the CQC says.

Map: find out CQC ratings in your area

This puts general practice significantly ahead of other healthcare providers. The report states: ‘Of all the sectors that CQC regulates and rates, GP practices have consistently received among the highest ratings.’

Alongside the 4% of practices rated outstanding, 6% of NHS acute hospitals and mental health services and 2% of adult social care services received the top rating.

But just 6% of GP practices were rated requires improvement – a huge difference compared to the two fifths (37%) of NHS acute services, a quarter (24%) of mental health services and one in five (19%) adult social care services handed the same rating.

The CQC rated 2% of practices as inadequate, together with 3% of acute hospital services and 1% of adult social care and mental health services.

But GP practices were significantly more likely to maintain their ratings upon reinspection than other NHS providers. Among GP practices initially rated good, just 2% dropped at by one rating level or more upon reinspection, compared with 26% of mental health services, 23% of adult social care services and 18% of acute hospitals.

Inadequate rating

For those re-rated after being found inadequate, all providers had similar improvement rates at around 80%.

BMA chair Dr Chaand Nagpaul said: ‘It is certainly encouraging to see that the NHS is providing good levels of care for patients, particularly in general practice where we know that GPs are consistently under enormous pressure, but it is worrying that almost one in four acute hospital services and almost a quarter of mental health services are having their performance affected by lack of resources, system pressures and chronic underfunding.

‘We are just one bad winter away from another crisis in our health system. The government should urgently bring spending on health in line with other leading European economies and produce a long-term strategy that addresses the fundamental workload and funding challenges that are overwhelming our health service.’

Sir David Behan, chief executive of the CQC, said: ‘The fact that the quality of care has been maintained in the toughest climate that most can remember is testament to the efforts of frontline staff, managers and leaders.

‘Many providers have used our inspection reports to improve, and we have seen improvements in safety in particular, although this area remains a big concern and focus for us.

‘However, as people’s health and care needs change and become more complex, a model of care designed for the 20th century is at full stretch and struggling to cope with 21st century problems.

‘The impact of this on people is particularly evident where sectors come together – or fail to come together, as the complex patchwork of health and social care strains at the seams.

‘If services are to deliver consistently for people, there must be better co-ordination of care to create a sustainable and effective health and care system. Staff and leaders can’t work any harder; the answer must be to work more collaboratively, not just between sectors but between agencies and professionals, supported and incentivised by the national health and care organisations.'

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