GPs demand end to 'culture of fear' around CQC inspections

Dozens of GPs have called for an investigation into the CQC's approach to practice inspections - arguing that its current methods have created a 'culture of fear’.

The letter, which calls for a full inquiry and overhaul of the CQC inspection process, expresses concern that GP practices have continued to be assessed during the pandemic in the face of heavy workload.

GPs behind the campaign, which picked up 40 signatures in less than 24 hours, said the watchdog's inspections can be 'aggressive and unreasonable' and 'have heaped undue pressure on colleagues causing not only stress, but also physical and mental health problems'.

Some GPs now feel 'harassed by the CQC and work within a culture of fear', the letter says. Its signatories called for the frequency of inspections to be reduced and for assessments to be suspended entirely during the pandemic apart from in exceptional circumstances.

CQC inspection

The letter comes just weeks after the CQC announced a review into 'longstanding concerns' over a potential bias against black, Asian and minority ethnic (BAME) GPs in its ratings. The RCGP has also called for an independent review into ratings for BAME GPs.

CQC chief inspector of primary care Dr Rosie Benneyworth said the watchdog remains committed to minimising the impact that regulation has on providers, and continues to be sensitive to the current circumstances - but that safety must remain a priority.

A group of GPs have written an open letter to CQC calling for a full inquiry and overhaul of the inspection process.

GPs supporting the campaign took to Twitter to share their experiences of CQC inspections. GP partner in Hillingdon, London, Dr Bushra Khawaja said: ‘We had a terrible experience where CQC inspectors were patronising, unprofessional and conducted a damaging inspection. Thankfully a decent team came in the following year and rated us as good. We did not even get an apology from the first team despite a formal complaint.’

The letter itself says it was prompted 'by the treatment of a GP colleague being asked to stock Furosemide by a non-clinical inspector'. It continues: 'Furosemide is a drug used in severe heart failure, and is virtually never administered in the community, even by ambulance or acute medical teams, let alone GP practices. It is therefore baffling that a non-clinical inspector can cause such a paper trail regarding a rarely used non essential medication.'

As of 12 March this year the CQC has carried out 132 on-site inspections since the start of the first UK lockdown on 16 March 2020 - representing a huge reduction compared with the same period last year, when 1,646 inspections were conducted.

COVID-19 pandemic

Dr Benneyworth told GPonline that safety needed to remain a priority for health services during these 'difficult and challenging times'. She said: 'We know that GPs and practice teams are under immense pressure, that is why we suspended routine, frequency-based inspections in March 2020.

'It is also why we worked with the sector to respond and adapt – finding ways to support providers while balancing our duty to provide public reassurance. Good regulation, like good care, is responsive and strives to work the best it can for both providers and people using services and we remain committed to minimise the impact that regulation has on providers.

'Our draft strategy on future regulation closed for consultation last week. The proposals outlined were based on conversations and feedback that we have from speaking with GPs and practice teams, people who use services and our inspectors. We are currently reviewing responses and will publish our strategy in the coming months.'

She added: 'We remain sensitive to the changing circumstances of providers, while making sure our regulatory role and core purpose to keep people safe are at the heart of every decision we make.'

The CQC suspended routine inspections last March following the start of the pandemic, and announced four months later that it would re-start inspections - including on lower-risk cases - from autumn, in a move condemned as 'inappropriate' by GPs.

Last month the CQC set out plans to move away from routine on-site inspections of GP practices as part of a consultation to improve how it assesses primary care services.

A link to the campaign can be found here.

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