MPs back CQC regulation of general practices

‘A useful tool in driving improvement, ensuring quality and giving the public confidence in the services they pay for’

The Care Quality Commission (CQC) has welcomed the strong recognition from Health Select Committee for the important role that regulation plays in helping patients to get the safe, high quality and compassionate care they deserve and for encouraging improvement across general practice in England.

The conclusions have been made in the committee’s report on primary care, published today (Thursday 21 April) and as CQC continues with its commitment to use its intelligence-driven, expert-led and specialised approach to regulation to rate every single general practice in England as either outstanding, good, requires improvement or inadequate. This is giving the public clear, accessible and reliable information about the quality of their services.

Already, CQC’s inspections are showing that the majority of GPs are providing good and outstanding care to patients, with 87% of practices have been awarded these ratings as of last Friday (15 April).

Also, at least 43 general practices have been able to exit special measures – the national process for ensuring there is a timely and coordinated response to inadequate care – because of improvements GPs have made, as expected and identified by CQC.

While the poor examples of general practice that CQC has uncovered through its inspections have been relatively few in number compared to those rated as good and outstanding, they have had the potential to significantly affect thousands of patients across the country, with issues including poor leadership and governance arrangements, out-of-date medicines, delays in processing prescriptions and inadequate employment checks. Without CQC’s regulation, this unacceptable level of care would have continued undetected.

In its report, the Health Select Committee concludes:

“We welcome Care Quality Commission inspection of GP practices and the benefit which it has brought for patients. Independent regulation supported by robust inspection is a useful tool in driving improvement, ensuring quality and giving the public confidence in the services they pay for. Since the CQC’s remit was extended to primary care [in April 2013, with CQC’s ratings inspection programme for general practices formally beginning in October 2014] it has played an important role in identifying failing and underperforming practices, closing some down and ensuring others improve. We reject the calls from the British Medical Association and the Royal College of General Practitioners to scrap the current regulatory regime. We urge them to work constructively with the Care Quality Commission to protect the public from the small minority of dangerous practitioners and to help to turn around underperforming practices.”

Elsewhere, the committee encouraged CQC, as with other regulators, to constantly examine its procedures and methods, so that the impact that regulation can have on the profession is kept to a minimum while ensuring that patients’ best interests continue to be the primary driver.

CQC supports and remains committed to this sentiment. Its strategy for the next five years – which CQC will publish next month and was consulted on earlier this year – will include plans to strengthen how it uses data to inform its work, to develop a single view of quality with providers, and to target and tailor its inspections to where it has the greatest concerns about care.

In a ‘statement of intent’ between NHS England, the General Medical Council and NHS England – also published today – the three organisations describe the approach they are taking together to improve the experience of regulation, both from the perspective of general practices and of GPs individually. This includes improving how information is gathered, shared and accessed between organisations and with practices; aligning regulatory and commissioning processes as much as possible and; streamlining oversight, regulation and contract management. A 'programme board' will be established between these and other organisations to take this work forward.

Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said: "I am pleased that the Health Select Committee has acknowledged the important contribution that our regulation of general practices makes to ensuring people get safe, high-quality and compassionate care.

“Introducing the first regulatory system in England for GP surgeries hasn’t always been plain-sailing but we have been guided by our strong public duty at all times, which is to work with the profession and others to achieve this common goal. We will continue to do so.

"Our inspections are allowing us to gain a deep understanding of the quality and safety of general practice that we have never had before in this country. Also, they are leading to real improvements in care, which we are able to celebrate, share and encourage others to follow.

“As we head towards having inspected every single general practice in the country at least once, we are making plans to evolve our model in response to what we have learnt and enabled. Working with our national partners, we hope that these changes will reduce any duplication of efforts brought on by our collective regulation and make the system more efficient, while staying true to our core purpose.”

Ends

1. Further information about the Health Select Committee’s report on primary care.
2. For further information about the General Practice Forward View (also referred to as the ‘GP roadmap’) and the ‘statement of intent’, please visit NHS England’s website.
3. As of Friday 15 April 2016, CQC has rated 3,358 active general practices in England. Of these, 136 (4%) are outstanding, 2,775 (83%) are good, 338 (10%) are requires improvement and 109 (3%) are inadequate. CQC expects to have inspected every general practice in England (registered on or before 1 October 2014) by the end of March 2017 as part of its comprehensive ratings programme.
4. As of Friday 15 April 2016, there are 110 general practices in special measures and 43 have exited the regime. The special measures process is designed to ensure there is a timely and coordinated response when CQC judges the standard of care to be inadequate. Further information about special measures.
5. CQC’s inspections of general practices so far have found a strong link between leadership and the quality of care being provided. Although the majority are providing good or outstanding care, the regulator remains concerned by the very poor care it has found in some practices through its inspections. Further information about what CQC has found, please read CQC’s State of Care report for 2014/15.
6. CQC has published a tool for GPs, with examples of the outstanding primary care it has found on its inspections.