Two in five practices put in CQC special measures later closed down

Two in five practices re-rated by the CQC following a stint in special measures have since been shut down, with just half managing to improve enough to leave the programme, according to the CQC.

Some 39% of practices re-rated after being placed into special measures following an 'inadequate' rating have now closed their doors for good, official data presented by the CQC has revealed.

A total of 238 practices have entered special measures as of this month, two years into the CQC’s overhauled inspection process that introduced the scheme.

Although 126 are still awaiting re-inspection or publication of their report, 112 have received a follow-up visit from inspectors to check up on their progress.

Of these, 49% improved enough to be rated ‘requires improvement’ or ‘good’ and leave the scheme, according to results announced by chief inspector for primary care Professor Steve Field at the Best Practice show in Birmingham last week.

A total of 44 special measures practices have now been de-registered, he added, equivalent to 39% of those to be re-rated.

Most of these (70%) elected to voluntarily hand back their registration after failing to demonstrate improvements, Professor Field said, but the CQC took legal action to forcibly close the other 13 (30%).

CQC special measures

With 5,500 practice inspections under its belt, this means just shy of 1% of practices inspected have ultimately closed down as a result of the CQC's overhauled inspection regime, with 0.2% closed forcibly.

The watchdog puts most practices rated inadequate into special measures to ensure they follow through with expected improvements. Affected practices are visited again by inspectors within six months to check up on their progress.

‘When you see those horror stories of GP surgeries that have been closed, you're actually talking about only 13 that we have stopped their registration out of 5,500,’ Professor Field said. ‘So the numbers are tiny – but they do cover many thousands of patients.’

General practice as a whole in England is ‘bloody good’, he went on to add. ‘If you're a patient in England, you're generally going to get good care wherever you are in the country – but there are pockets where it’s poor.

‘That is unacceptable, and I would believe all of you would agree. Collectively, we've got to do something about that.

Practice improvements

‘For the practices that go into special measures, half of them improve – the question is why do the other half not improve, and why are some so bad they have to be closed?

‘Of course, we don’t want to close practices – because if we close a practice then you’ve got to find another practice for those patients to go to, and that’s disturbing for the patients, disturbing for the local population and it’s not good for us as GPs – because there are people out there who don’t like general practice as much as I do, who would like to cause us some difficulties.

‘And what we've got to do collectively is try to provide the best care we possibly we can, and we know the majority of practices do that – there is no excuse anymore.’

GPC deputy chairman Dr Richard Vautrey said: ‘I think the fact that half have been able to resolve their local issues and return to providing good levels of care is a positive thing for those individual practices.

‘When an assessment has been made for a practice, every attempt should be made to support them to resolve their issues. Often those are complex and come with a long history of underinvestment, which not just CCGs but PCTs before them have been unable to provide appropriate support for.

‘There needs to be a great deal of sensitivity and understanding about the particular situations practices find themselves in, often not down to any fault of theirs. The key is providing tailored support to them rather than a one size fits all approach.’

Photo: Pete Hill

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