The RCGP has called for a temporary pause of CQC routine inspections of GP practices due to concerns about the current regulation system.
The college’s governing council also called for an end to ‘simplistic’ one-word ratings currently used in CQC inspections, during a meeting on Saturday (30 November).
The proposed pause would only be for routine inspections, as the college said it is ‘clear’ that inspections of practices where patient safety concerns have been raised should continue.
The CQC should also explore alternatives to the one-word ratings that would provide ‘greater nuance, support and transparency’, according to the council.
RCGP chair Professor Kamila Hawthorne said that continuing to apply the current inspection regime would be ‘harmful’, diverting resources and attention away from patient care and perpetuating a ‘distorted and inconsistent’ picture of GP services.
In a letter to primary care minister Stephen Kinnock and CQC interim chief executive James Bullion, she said that the pause and revaluation of the system would be ‘especially important’ for smaller providers such as GPs, where the ‘personal and reputational’ impacts of an adverse inspection outcome can be felt much more acutely.
Professor Hawthorne said that this call shows ‘the strength of feeling’ among RCGP members that the CQC is ‘not fit for purpose’.
‘We regularly hear reports that preparing for CQC inspections is highly and unnecessarily stressful at a time when GP teams are already working under intense pressure, and that the CQC’s processes are ineffective and, in some cases, discriminatory against practices run by GPs from ethnic minorities,’ she said.
‘We are therefore calling for a temporary suspension of routine CQC inspections until an improved, cost-effective and evidence-based approach to assessments and inspections has been agreed and implemented.
‘Of course, patient safety is our number one priority, and inspections of practices where patient safety concerns have been raised should continue.’
It comes after earlier this year, a major review into the CQC commissioned by the Government confirmed ‘significant failings’ in the way the watchdog operates.
The damning review found that CQC ‘lost its credibility’ within the services and providers it inspects, with a ‘lack of consistency’ and transparency observed in CQC ratings of GP practices.
The CQC own internal review argued that a ‘fundamental reset of the organisation is needed’ and that the CQC ‘will never be able to deliver on its objectives’ if the current structure is maintained.
Professor Hawthorne added that pause in routine inspections will allow for the ‘sensible’ recommendations outlined in the recent reviews and in her letter to be implemented, as well as serving as an opportunity for the CQC to ‘rebuild trust, credibility and expertise’.
She added: ‘Similarly, we believe that moving away from a rating system that relies on simplistic one-word ratings, and evaluating alternatives that would provide greater support and a more nuanced and rounded view, would be an important step to creating a fairer and better regulation system that practices and patients can have confidence in.’
In response to the RCGP’s call, a CQC spokesperson told Pulse: ‘A central part of effective regulation is working with providers to make sure we have a system that works for them, while also giving assurance to people who use services about the quality of care that they can expect.
‘As we continue to build on the findings of the reviews by Dr Penny Dash and Professor Sir Mike Richards, we will continue to engage with providers and the public as we develop our approach and rebuild trust and confidence.’
Last week, the CQC said it is rolling out ‘some key changes’ to their assessment approach from today, as it will stop scoring and reporting at evidence category level for provider assessments, but it will continue to use the five questions (safe, effective, caring, responsive and well-led) and a four-point ratings scale (outstanding, good, requires improvement and inadequate).
It said that the changes will mean that the CQC will be able to deliver more assessments, ‘at a faster pace’.
In an update to GP practices, the watchdog said: ‘Assessments using our current scoring approach take too long and mean we are not able to complete assessments in a timely way or complete enough assessments to give an up-to-date view of quality for the public and providers.
‘We have also heard that our scoring model is too complex and hard to understand.
‘We will still use our published evidence categories to guide what we look at during assessments and to produce a judgement for individual quality statements. Our ambition remains to deliver regulation that is driven by people’s experiences of care.
‘We will update our guidance to provide more information on what this change means for our assessments of providers.’
Last month, GP leaders asked the BMA to negotiate the removal of the CQC’s single-word ratings when assessing general practice services.
with dwindling funds and manning…why NOT cease this CQC phenomenon altogether and use AI to improve practice?
Just refuse to let them in, it’s trespass on private property if intruders don’t leave on request. Call the police.
Agree with Dr No, as this is the same action, we would take with any other alleged vandals attempting to gain repeat access to and allegedly damaging or negatively affecting our GP practices or Primary Care and the healthcare sector in general for that matter . Considering the recent assessment of the CQC being not fit for purpose (as if we didn’t know) , if not the police, then who then is going to regulate this aberrant regulator in rhetorically speaking special measures who in my view will not improve but only get worse .
They are in my opinion top of the list of the reasons as to why one might want to give up medical practice and should be added to the long list of other world issues having a negative effect on all our mental health.
Mr Streeting said the government was ‘taking steps to reform the CQC , to root out poor performance and ensure that patients can have confidence in its ratings once more’ – perhaps those being regulated by a supposedly unfit regulator ought also to have confidence, which is and has been sadly lacking added to the harm caused by excessive wasted time, costs and tick box reports.