CQC has announced plans to introduce a new special measures scheme for GP practices from October 2014.
Practices offering poor care will be given deadlines to make improvements and will be faced with closure if they fail. This will coincide with CQC starting to rate 8,000 NHS GP practices on the basis of whether they are outstanding, good, requires improvement or inadequate. As CQC develops its special measures approach, the body will work closely with NHS England, the General Medical Council, the Royal College of GPs and other professional bodies.
If CQC inspectors rate a GP practice as ‘inadequate’ the service will be given six months to improve. Practices that fail to make improvements will be put into special measures, after which they will be given a further six months to meet the required standards. At the end of their period in special measures, if CQC still judge them to be inadequate, their CQC registration will be cancelled and their contract with NHS England will be terminated.
In some cases, when it is deemed that poor care is putting patients at risk or that a practice is not capable of improving on its own, CQC will put the practice into special measures immediately.
Speaking about the scheme, Professor Field said: “Most GP practices provide good care. We have confirmed this in our pilot inspections so far. But we can’t allow those that provide poor care to continue to let their patients have an inadequate service. I want to do all I can to drive up standards in those that are not providing the services people deserve. We need to have a clear framework and a process to respond to those GP practices that are providing inadequate care to ensure that they can’t continue to provide inadequate care indefinitely. When health and care organisations fail the people to whom they provide care, it’s important that failure is identified quickly and the action is to ensure services for people improve. That sits at the heart of special measures.
CQC’s crackdown will see it use patient complaints and information gathered by local bodies such as HealthWatch and whistleblowers in deciding which surgeries are putting patients at risk. Some practice nurses and practice managers already ring CQC’s hotline to raise concerns about their surgery.
Dr Chaand Nagpaul, chair of the British Medical Association’s (BMA) GP committee, said that all patients should receive excellent care from their GP practice and that most do. However, he warned that “it is important not to create a counterproductive blame culture based on isolated examples that would wrongly damage patient trust in wider GP services.”
Problems at a surgery may be because of underfunding, difficulty in recruiting staff or the poor state of the premises. Dr Chaand Nagpaul further added that “The last thing we want is for GP practices to close when what patients need is high quality, local services.”