Most GPs say scrapping revalidation and CQC checks would not affect patient safety

Around two thirds of GPs say scrapping revalidation and CQC inspections would make no difference to patient safety - or could improve it, a GPonline poll reveals.

(Photo: mtreasure/Getty Images)
(Photo: mtreasure/Getty Images)

The latest GPonline opinion survey found that around two thirds of GPs think scrapping revalidation and CQC inspections permanently - effectively adopting changes seen during the COVID-19 pandemic on a permanent basis - would improve or have no effect on patient safety.

Just one in five of 572 GPs who responded said scrapping revalidation would have a negative impact on patient safety, while 9% said it would improve it, 60% said it would not affect patient safety and 12% were unsure.

On CQC inspections, 10% said scrapping these checks would improve patient safety, 54% said it would not affect patient safety, 21% said it would have a negative impact on patient safety and 15% were unsure.

GP bureaucracy

A majority of GPs responding to the poll also said they did not think revalidation or CQC inspections are worthwhile - and less than half agree that GP appraisal is worthwhile.

The findings come as the health secretary Matt Hancock set out plans for a 'bureaucracy busting' drive from the DHSC. Last week he said that the pandemic had 'proved there's bureaucracy that our healthcare system can do better without'. He urged GPs and other staff to speak out about pointless red tape in a consultation on the issue.

Both the RCGP and the BMA have previously called for a major overhaul of red tape for general practice following the pandemic - warning that reductions in bureaucracy to allow practices to get on with providing patient care had made the job 'doable' again.

Responding to the GPonline findings, RCGP chair Professor Martin Marshall said: 'Throughout the COVID pandemic general practice has significantly changed the way it works, and we’ve seen that GPs and our teams work well when they don’t have to engage with unhelpful bureaucracy.

'As we look to post-COVID general practice we need to evaluate the new ways we’ve been working and decide what we’d like to retain in the best interests of patient care and keeping general practice sustainable.

NHS regulation

'These findings show that approximately two thirds of the 572 GPs surveyed thought that some of the regulation changes which we’ve seen in response to COVID should be implemented long-term – and that the vast majority of these GPs felt that reduced regulation would not risk patient safety.

'This is similar to what we have been hearing from our members and as such, the college has called for the reduction in regulation to continue post-COVID.'

The college chair said regulation could be helpful to identify practices and GPs in need of support and that appraisal and revalidation could be 'a supportive experience' for some doctors. But he called for  a move away from 'tick-box bureaucracy' in favour of a system that trusts GPs to get on with work rather than limiting excessively the time they can spend with patients.

He added: 'The fact is 95% of GP practices are rated good or outstanding. For too long, tasks associated with regulation have taken up too much time in general practice and the knock-on effect is that we have had less time with patients. We must learn from the COVID pandemic – and we have shown throughout that general practice can work well and safely without so much regulation.'

Patient safety

CQC chief inspector of primary care Dr Rosie Benneyworth said: 'As we look to lessen the impact of regulation that providers may feel, we also have to balance that with the important role it plays in making sure that people have access to safe, high quality care.'

She acknowledged that the vast majority of GP practices were good or outstanding - but pointed out that providers were most likely to need help with the 'are services safe' key question - and argued that reports helped to identify where support was required.

But Dr Benneyworth added: 'As COVID-19 has resulted in fundamental changes to the way that care is delivered, and many providers will be working in new ways, we will need to be more flexible and responsive in the way we regulate.'

GMC director for registration and revalidation Una Lane pointed to changes adopted during the pandemic such as rescheduling revalidation dates and more flexibility around revalidation.

She added: ‘Appraisal and revalidation give doctors the opportunity to show that they are up to date and fit to practise - to their patients, colleagues and employers. It is also an opportunity for doctors to reflect on their practice and support their professional development. We know from previous research that many doctors value this opportunity. We are reviewing our guidance to make sure it continues to meet these objectives without adding unnecessary burden.

‘We are working with the NHS across the UK’s four countries on resuming appraisal in the autumn to make sure it provides the support that doctors need in these challenging times and also focuses on their wellbeing. As the system continues to adapt and recover, we are also working with stakeholders to consider further changes to both appraisal and revalidation so that it supports the needs of both doctors and providers.’

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