Responding to a CQC consultation, the BMA said it had issues with the way general practice was inspected in the CQC's overhauled regime and had ‘serious concerns’ about displaying ratings in practices.
In the letter, BMA’s head of health policy and economic research Raj Jethwa warned that an overall performance rating was ‘simplistic’ and could ‘not accurately capture the complexities of delivering healthcare’.
He added that, even by looking at different key patient groups, the CQC inspection could ‘not cover the entire spectrum of care delivered by that provider’.
He said: ‘An overall "requires improvement" or "inadequate" rating might conceal areas of excellent care within that provider, possibly in a specialty or service more relevant to the individual patient seeking the information.
‘And of course the converse would also apply, that an overall "good" or "outstanding" rating might conceal areas of poor care in a speciality or service more relevant to the individual patient concerned.’
Damaging for patients and staff
Displaying CQC ratings would be fraught with problems, he said. As ratings are only given once every three years, there is no guarantee that they represent an up-to-date portrayal of services delivered by the practice one or two years after the rating was given.
Displaying poor ratings could also create ‘unnecessary anxiety’ among patients or carers who could not feasibly choose to go to a different practice.
It could also have a ‘damaging effect’ on staff morale, a problem already rife in the profession, and contribute further to the recruitment and retention problems facing many practices.
The BMA's stance follows a vote by delegates at the annual LMCs conference in May that they ‘vehemently opposed’ the CQC’s plans for a ‘simplistic’ rating system for practices.
In addition to being displayed in practices, ratings will be made publicly available online just a day after practices are forewarned of their inspection result.
