Professor Nigel Sparrow: CQC recognises the challenges GPs face

CQC inspections are helping to drive up standards in primary care, says the watchdog's GP adviser Professor Nigel Sparrow. But in the current challenging climate for GPs, the CQC is keen to work with the profession to keep the burden it places on practices to a minimum.

When the CQC completed its recent inspection programme of GP practices across England and published The State of General Practice in England, 2014-2017, it gave an unprecedented view of the quality of general practice in England.

This showed that the vast majority of GPs in England were delivering good or outstanding care (86% and 4%, respectively), with further improvements seen in October’s State of Care report where the percentage of practices rated good rose to 89%. At the time we said that this was despite GPs across all regions of England facing very real pressures around workload and workforce. This is still true today.

Even with such challenges, we saw amazing examples of outstanding care that truly understood and responded to the needs of the local community and exhibited collaborative, supportive working right across the country and for the various population groups they serve.

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Many of the practices that we rated as outstanding had strong leadership in place and had developed innovative working styles that led to direct improvement of patients’ experiences and care outcomes – as well as indirect improvements, like better working environments and developing new ways of working to use practice staff to their best potential and ability.

We know that there is a challenging climate for GPs and we are aware that the impact of regulation is often confused with simply preparing for and having an inspection. In reality, regulation is about ensuring that people receive safe, effective care and encouraging improvement.

Inspection forms the basis of a development appraisal, challenging those providers who fall short and celebrating those who excel. The basis of inspection itself being agreed and clear expectations and standards developed with patients and the profession.

Improving care

By comparing those fundamental standards to what we find on inspection, we are able to give practices a clear idea where they need to focus their efforts in order to mitigate risk and ensure patients receive high-quality, compassionate care. In fact, when we compared initial findings to those of practices we re-inspected, we saw the number of services rated inadequate and requires improvement decrease, while the number of services rated good went up.

Quite simply, more people had access to a better standard of care when we revisited practices than at the start of the programme and that is something GPs and practice teams should be proud of.

Looking to the future and how regulation will continue to develop, the Regulation of General Practice Programme Board (which includes all organisations that are involved with regulation or have an oversight of regulation) is working to reduce duplication and workload associated with regulation.

As we look to implement the results of the recent consultation on the next phase of regulation, collaboration with GPs and professional bodies will be essential to ensuring that regulation does not place unnecessary pressure on practices, or duplicate data requests, and continues to drive high quality care for people across the country.

  • Professor Nigel Sparrow is senior national GP adviser to the CQC

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