'Inaccurate' risk bands do not reflect practice quality of care, CQC lead admits

Practices that serve specialist populations or have opted out of the QOF cannot be accurately assessed by the CQC's 'intelligent monitoring' system, a leading official for the watchdog has admitted.

CQC ratings: risk scores do not align with inspectors' findings
CQC ratings: risk scores do not align with inspectors' findings

Speaking last week at a Westminster Policy Forum event, CQC’s deputy chief inspector for primary care Dr Janet Williamson said there were some 'inaccuracies' in the intelligent monitoring tool's risk banding system, adding that it could not fairly represent the quality of care provided by many practices.

Despite the admission, she said the watchdog will not be scrapping the controversial system, which publicly identified one in six practices as 'risky' before they had been visited by inspectors.

Dr Williamson’s comments mark the first time the watchdog, which has staunchly defended its intelligent monitoring system in the past, has conceded that there are some errors in the system - although it did alter how they were calculated after a torrent of complaints from GPs.

CQC data criticised

The CQC received heavy criticism when it published the ‘misleading’ data in November, which resulted in hundreds of practices being branded as ’failing’ in local media.

GP has previously revealed that more than 10% of practices rated ‘good’ or ‘outstanding’ after inspection were labelled high risk by the CQC data.

Dr Williamson told the Westminster event: ‘It's unfortunate that the bandings were turned into a risk rating, because that was never the intention.

'It is one source of intelligent monitoring - it's not the complete picture - and we know there have been some inaccuracies in that banding data.

‘We know that where practices have opted out of QOF, where there are practices that have specialist services for the homeless or university services, that actually the bandings don’t particularly reflect the type of service. That is something that we have to work through.’

System will not be scrapped

The GPC has called for the ‘flawed’ system to be scrapped, but Dr Williamson said it was here to stay – and revealed that the CQC plans to constantly reassess practices under the system.

She said: ‘The bandings are being reviewed and updated as we speak; it was never been meant to be a one-off exercise. The bandings use data that is almost 18-months old and we need to use current data.

‘So they are being reviewed, but the important message is the bandings are one part of a number of pieces of intelligent monitoring that will build up a picture that will potentially give us an indication of where to look, but it’s not an absolute.’

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