GPs hit back over morale-sapping impact of inaccurate CQC risk scores

Practices have hit back as the first rounds of CQC inspection reports have revealed 'unacceptable' discrepancies between the watchdog's intelligent monitoring risk scores and official inspection ratings.

Rating: CQC risk scores hit morale
Rating: CQC risk scores hit morale

A GP analysis revealed that a practice rated 'outstanding' by the CQC was publicly labelled 'high risk' in November when the watchdog published its controversial 'intelligent monitoring' data.

The CQC publicly identified St Thomas Medical Group, in Exeter, as among the highest risk practices in England on its intelligent monitoring website last year. But after visiting the practice, inspectors rated it among the country's very best.

Practice manager Gill Heppell said her practice’s risk score had impacted on staff morale and was built on inaccurate data. She described inspection day as a ‘positive but gruelling’ experience.

She said: ‘As soon as we saw the [risk] data, we checked alongside our own reports.  Some of the data was inaccurate and some highlighted coding errors on the practice's behalf. 

Staff morale affected

‘We didn't have any negative feedback from patients, but it did have an effect on staff morale. We were fortunate that our report was soon to be published, and we were confident that it would reflect well on the care we provide.’

Others in a similar situation have come out less unscathed. Nearly one in 10 (9%) of practices found to be ‘good’ so far were previously called out as high risk on the CQC website.

At least one of these practices, the Balance Street Health Centre in Uttoxeter, is highlighted in a local newspaper’s league table as among the ‘worst doctors in Stoke-on-Trent and Staffordshire’, despite its actual inspection proving this is not the case.

Practice manager Karen Arthur told GP her practice was allocated to band 2 for factors such as ’10 patients out of 1,000 not having their BP in range at the time’ and ‘one patient not being offered smoking cessation advice’.

Unacceptable risk rating

She said:  ‘We received our intelligent monitoring report in November, even though we had been inspected on 3 October.

‘I do not think it is acceptable to be labelled as a high risk practice when we were visited before the intelligent monitoring report was published.’

One senior primary care lawyer has said practices could take legal action for defamation against the CQC if they are unfairly labelled high risk.

The disparity between actual ratings and risk ratings has prompted renewed calls from GP leaders for the CQC to scrap its 'stupid' intelligent monitoring system. The GPC claims the tool is ‘misleading patients and damaging the CQC’s reputation’.

In further examples, two of the five practices given the lowest rating of ‘inadequate’ were placed in the lowest risk category – band 6. Only one of the ‘inadequate’ practices was placed in a high-risk band by the intelligent monitoring tool.

GPC deputy chairman Dr Richard Vautrey said: ‘This shows how useless the intelligent monitoring system is as a marker for quality of practice, and it’s no wonder that the profession has no confidence in that process.’

The CQC has maintained that its intelligent monitoring risk scores ‘are not judgments’ on practices and should not be interpreted as such. The watchdog says only inspection ratings reflect its view of whether the service provided by a practice is ‘safe, caring, effective, responsive and well-led’.

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