CQC on Failing GP Practices

Topics covered: Ridouts professional advice

CQC has released information about failing GP practices. In the first national inspection of more than 900 GP surgeries in England, CQC has found one in three is failing to meet basic standards.

Overall, concerns were expressed about a third of practices. According to CQC, in nine cases, the failings were so serious that they could “potentially affect thousands of people.”

The inspections were targeted mainly at those practices deemed to be high risk ahead of next year’s rollout of the first national GP inspection regime. Of the 910 inspected, 80% were targeted because of known concerns. The remainder were chosen at random.

Among the problems identified across the board were concerns about the handling of medicines and cleanliness. CQC said it had found examples of emergency drugs being out of date and vaccines not kept in properly regulated fridges which could damage the effectiveness of the injections and cause outbreaks of disease.

CQC is aiming to inspect all 8,000 practices over the following two years and give them one of four ratings:

1.       Outstanding

2.       Good

3.       Requires improvement

4.       Inadequate

Professor Steve Field, CQC’s new chief inspector of GPs, said these inspections would end an era where poor care was tolerated in general practice. He said the problems highlighted in the checks had sometimes been known about locally for years. “We are hearing about problems that people are very worried about but no-one has tackled in the past. We need to make sure that everyone, from the most well-off to the most disadvantaged, can get access to really good care.”

Professor Steve Field has set out his new approach of inspecting and regulating all GPs and out-of-hours services in the document ‘A fresh start for the regulation and inspection of GP practices and GP out-of-hours services.’

CQC’s new approach to inspections of GPs and GP out-of-hours services will start in April 2014.

The key changes are as follows:

·         Better, more systematic use of people’s views and experiences, including suggestions and complaints.

·         New expert inspection teams including trained inspectors, clinical input led by GPs and nurses,

practice managers and GP Registrars.

·         A rolling programme of inspections carried out systematically in each clinical commissioning group (CCG)

area across England.

·         Inspections of GP out-of-hours services to be incorporated into CCG area programmes.

·         A focus on how general practice is provided to key patient groups, including vulnerable older people,

mothers, babies and children.

·         Tougher action in response to unacceptable care, including where necessary closing down unsafe practices.

·         Ratings of all practices to help drive improvement and support people’s choice of surgery.

·         Better use of data and analysis to help CQC to identify risk and target their efforts.

·         Clear standards and guidance to underpin the five key questions CQC ask of services: are they safe,

effective, caring, responsive and well-led?

·         Close collaborative working CCGs and Local Area Teams of NHS England to avoid duplication of activity.


Professor Steve Field said, “we need to make sure that everyone, from the most well-off to the most disadvantaged, can get access to really good primary medical care; this is something which I intend to champion as Chief Inspector. When something goes wrong in general practice, it has the potential to affect thousands of local people. For example, poor storage of vaccines can lead to health problems years into the future and have a huge impact on the population as a whole. GPs don’t work in isolation, so we will also be considering the quality of communication between out-of-hours care and other local services, including GP practices, care homes and emergency services.”

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