Half of GPs say changes made because of CQC inspections have not improved care

CQC inspections have helped drive the majority of GP practices to make changes to the way they work, but half are doubtful that the changes helped improve patient care, a GPonline poll suggests.

Two thirds (64%) of practices made changes to the way they work either in preparation for a CQC visit or after inspectors, according to the poll.

However half (51%) of those who did make changes said they did not believe care at their practice had improved as a result of changes they had made.

Some 27% said that the changes had helped improve patient care, while the remaining 22% said they did not know.

The survey of over 400 GPs in England also found that one in six respondents said that their practice had made no changes at all.

The poll comes after the CQC finished earlier this year inspecting all practices under its current inspection regime – which introduced its four-point rating scale.

Its method of assessing GP practices is set to be overhauled again this coming October, three years to the month after it launched the current scheme.

CQC inspections

A consultation on the changes ended earlier this month, and the CQC said the outcomes from this are expected ‘later in the year’. The new scheme is expected to bring in a more collaborative approach to inspections, which will see practices send data to the CQC in return for having fewer inspections.

In the first wave of inspections, the majority of practices have passed with flying colours, with 88% achieving good or outstanding ratings.

With only 10% rated requires improvement and 3% inadequate, the current poll results suggests that even many well-performing practices have felt compelled to make changes due to CQC requirements.

Map: How have GP practices fared in CQC inspections?

Most respondents were critical of the CQC, with one describing it as ‘a huge amount of work for relatively small gains’ – a sentiment echoed by many others.

Some of the respondents said they felt the changes they had made were superficial and, at worse, negatively impacted on care.

One GP said: ‘Don’t worry, we now have disposable couch curtains and expensive towel dispensers, although there is really no evidence this makes a jot of difference to patient safety.’

Another said: ‘Large amount of paperwork; no change to clinical care. Significant detriment to clinical care around time of inspection as having to get locums to cover surgeries while partners sorted work out.’

Others supported the idea of some 'form of regulation', but some of these questioned whether the CQC’s current processes ‘necessarily equates to quality of patient care’.

Patient safety

‘A good idea in principle, but the time taken to prepare for inspection was disproportionate to its value,' warned one GP. 'It has been useful for weeding out some poor surgeries, but people could have told you which surgeries were poor before the inspection.’

One described their inspection as an ‘overall positive experience’. They added: ‘I feel the process of CQC inspection helped the practice reflect upon its organisation and protocols.’

‘We had CQC visit last month,’ another GP said. ‘Everyone gets stressed about visit – but it is good way to refresh all regulations and protocols.’

CQC deputy chief inspector of general practice Professor Ursula Gallagher said: ‘Regulation has an important role to play in making sure that people get high-quality, compassionate care and it is encouraging if inspections are prompting providers to make sure patients receive the care they have a right to.

‘It is also encouraging that we are seeing GPs taking on board the findings from inspections and using them to drive improvements for patients who use their practice.

‘However, there is more to regulation than just inspection and we recognise that many GPs are struggling to meet increasing demand.

‘This is part of the reason we recently consulted on changes to the way we regulate general medical practice, with increased emphasis on monitoring and proposed changes to inspection intervals, and we hope that GPs have taken the opportunity to share such concerns with us – the response to this will be published later in the year.

‘CQC is a learning organisation and we are committed to working with practices to make sure that regulation works for patients and providers.’

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