How staffing levels can affect your CQC inspection rating

A recent poll by GP Online found that four in five GP partners said that their practice had been unable to recruit a locum doctor when they needed one within the past six months.

Locum GPs have become increasingly important in recent years given the current workforce crisis and the survey also found that nearly two thirds of GPs said that use of locums has increased significantly over the past six months in practices where they work.

With it becoming increasingly difficult to recruit locum doctors, coupled with the workforce shortage, GPs are under unparalleled strain. This could also pose a threat to the inspection ratings from the CQC for GP providers, particularly in relation to Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Workforce crisis

In 2021 GP practices delivered an unprecedented total of 367m appointments. In March 2022 GP appointments were up a further 5% from the levels in March 2021. Another year of continuous high demand is to be expected.

Local Medical Committees have warned throughout the early part of 2022 that practices have been struggling to cope with staff shortages, which have included staff shortages as a result of COVID-19 absences. But, as discussed above, practices are without the ability to easily bring in locum cover.

Practices that are struggling to recruit and retain staff, as well as unable to find locum doctors, are in real danger of falling short of their responsibilities owed under Regulation 18.

What is Regulation 18 and what does it mean for GPs?

The purpose of Regulation 18 is to ensure GP providers deploy enough suitably qualified staff, who are experienced and competent.

There is no set figure for the amount of staff the CQC would expect of each GP provider to deploy to comply with this regulation. Instead, to meet the regulation practices must demonstrate they have sufficient numbers of competent staff which meet the needs of the people using the service.

However, a growing number of GP providers may be falling short of this expectation if they cannot keep up with the rising demands from patients amidst a staffing crisis.

If the CQC inspects a GP service and establishes it does not have enough suitable staff deployed, or that staff are not supported to carry out their duties they are employed to perform, or failing to meet professional standards expected of them, the regulator may establish a breach of Regulation 18.

The consequence of this would be that your practice could not be rated any higher than ‘Requires Improvement’. This is because of the CQC’s ratings limiter policy which states any provider with a regulatory breach is capped at ‘Requires Improvement’. This has drastic consequences for practices because they have to display the rating via posters in the surgery or on their website.

Can GPs challenge the CQC Inspection findings?

GP providers can challenge the CQC inspection findings through a factual accuracy comments (FAC) challenge and this is highly encouraged should your practice find itself in this position.

GPs should not hesitate to challenge the CQC’s findings if they believe it is not a fair representation of their service. The FAC process allows a practice to challenge the initial draft inspection report from the CQC, and put forward its opinion on matters of dispute.

Ridouts can assist you with the FAC process by examining and evaluating evidence, articulating your perspective clearly, and rebut the CQC in any legal inaccuracies, errors or omissions. Without any challenge the CQC’s position automatically becomes accepted and perceived as the truth. This is problematic as it can lead to further enforcement action and have serious commercial consequences for your business.

The current staffing crisis means many more practices could find themselves in this precarious situation, especially if they are unable to hire locum doctors. If your GP service is negatively rated in an inspection report do not hesitate to contact us. At Ridouts we specialise in providing GPs with bespoke advice tailored to their needs to help navigate the regulatory demands of the CQC.

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