Network-level CQC inspections could leave GP practices facing 'double jeopardy'

GP practices could face 'double jeopardy' if the CQC carries out primary care network-level inspections in tandem with checks on individual practices, the BMA has warned.

BMA GP committee chair Dr Richard Vautrey told GPonline that the watchdog must continue to regard practices as individuals, following the creation of primary care networks (PCNs) earlier this month. He argued against the idea that a shift to network-level inspection could be a way to ease pressure on general practice.

The Leeds GP said: 'We wouldn’t want PCNs to be seen as an organisation in the way that other NHS organisations are examined and rated.

'The CQC has looked at practices that operate across multiple sites - superpractices - and considered whether they could inspect some but not all premises from which they operate. But this would not be appropriate for PCNs, whose member practices need to continue to be seen as individual practices.'

CQC inspection

The GPC chair warned that if practices faced network level-inspection alongside existing CQC inspections and ratings, it could 'increase pressure' on GPs by leaving them facing the 'double jeopardy' of two tiers of checks.

He added that lead practices within each PCN, however, could face additional inspection if the extra responsibility they take on through this role differs substantially from the existing service they provide.

Around 99% of GP practices in England have now joined a PCN. In each, a 'lead practice' has been identified, which the BMA has described as a 'focal point for engaging additional workforce and entering additional contractual arrangements on behalf of the PCN'.

These practices could also employ network staff to support member practices, and network-level funding will be paid to these lead practices to distribute to others.

Provider role

The CQC has suggested previously that some PCNs could face inspection if they take on provider roles, although GP leaders have said this is unlikely in most cases because the groups are set up as an extension of practice contracts.

The watchdog's inspection system already considers collaborative working between practices to an extent through questions such as: 'Are there positive and collaborative relationships with external partners to build a shared understanding of challenges within the system and the needs of the relevant population, and to deliver services to meet those needs?', and 'How well do staff, teams and services work together within and across organisations to deliver effective care and treatment?'.

CQC deputy chief inspector of general practice Ruth Rankine said: 'We are working with NHSE, NHSI and CCGs to understand how PCNs are developing as well as gathering our own intelligence to better understand how CQC may work with these new bodies - with such potential variation in how they work, we will look at each of these emerging models on a case by case basis.

'We know from our inspections of general practice and local system reviews that a collaborative approach can have a real impact on peoples’ experiences across health and care, and that for most people, their GP is the first port of call when seeking help.'

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