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Inadequate GP practices to be placed in special measures and offered help to improve
All GP practices that are found to be Inadequate by inspectors will be placed in special measures and offered a package of help to improve at the earliest opportunity, under proposals announced today by the Care Quality Commission.
CQC has been working with NHS England and the Royal College of General Practitioners to develop a pilot programme of intensive support to practices that are placed in special measures.
The regulator of health and adult social care has set out its updated plans for how it will deal with GP practices providing inadequate care. CQC is seeking feedback on these plans before finalising the approach for April 2015.
CQC proposes that when it rates a general practice as Inadequate overall – the practice will automatically be placed into special measures, opening the way to a package of support from NHS England. If its rating has not improved within a year then CQC will cancel its registration. In those circumstances NHS England will ensure that patients registered at the practice are able to continue to access GP services.
CQC first announced that it was introducing ‘special measures’ for GP practices in August 2014 to ensure a timely and coordinated response to GP practices providing inadequate care: this will ensure that practices are not allowed to continue to provide inadequate care to patients. Since then, CQC has been working with its partners to develop what this could look like and testing it out in early inspections of GP practices.
The special measures regime will work alongside CQC’s existing powers. If CQC has serious concerns about a GP practice then it will take immediate action so that people get safe, high-quality and compassionate primary care.
Prof Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said: “Our inspections are showing the majority of general practices are providing good care, which should be commended. Looking at the inspections we have published so far – the overwhelming majority have been rated Good or Outstanding. This is fantastic news and I hope the minority of practices that are not providing this level of care can learn from what these are doing.
“However, when we find that general practices are providing Inadequate services, the public expects us to take action and our special measures regime will give practices clear deadlines to make the necessary improvements.
“We will only cancel the registration of a GP practice if we think it is absolutely necessary – and in any case our priority will be to help the practice improve, if that is appropriate. In these situations we will work closely with NHS England who will ensure that people registered at that practice continue to have access to safe and high quality general practice.
“Our priority is in making sure patients receive safe, high-quality and compassionate care and in supporting services to improve.
“We are now in the final stages of developing the special measures regime and I would like to thank everyone who has been involved so far and encourage anyone who has an interest to share their views with us.”
Professor Nigel Sparrow, CQC’s Senior National GP Advisor, said: “The idea behind special measures is to drive improvement. We know there is much good care being provided by GPs, but where people are not getting the services they have a right to expect, practices must improve. When a practice has been rated as Inadequate, special measures will ensure that the practice can access the support to improve that is available from NHS England.
“Good quality local GP services mean a stronger local health services overall, with different parts of the health service working well together in the best interests of patients and the public.”
Dr Mike Bewick, Deputy Medical Director, NHS England, said: “Closing a GP practice in response to quality concerns would be very rare, and the first response will be work with GPs, LMCs and CCGs to help turn affected practices around. In all circumstances, patients can be reassured that their safety is the NHS' overriding concern."
Dr Katherine Rake, Chief Executive of consumer champion Healthwatch England, said: “This is a bold step by the CQC but it’s exactly the sort of thing patients want to see.
“Hearing that your family doctor is failing to meet basic standards is deeply troubling, and people need to know that tough measures are being put in place to drive improvement and ensure they get the same high quality care as everyone else.
“Whilst we sincerely hope that no surgeries will be forced to close, where such action is necessary to protect patients, it is absolutely vital alternative access to GP care is provided.”
CQC has been inspecting and rating GP practices since October based on its new inspection model, which uses specialists teams that assess services against what matters most to people who use them: are they safe, caring, effective, responsive to people’s needs, and well-led.
CQC will be seeking further views from anyone who wishes to have their say on its proposals until Thursday 5 February.
Twitter: @CareQualityComm #specialmeasures
For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07789 876508. For general enquiries, call 03000 61 61 61.
- Last updated:
- 30 May 2017
Notes to editors
- For further information about CQC’s proposals regarding its special measures regime for primary care and how people can share their thoughts, please visit: 'An update: CQC's proposals for special measures for GP practices'.
- For further information about how CQC rates general practices, please visit: 'New GP inspections will lead to ratings'.
- There are over 7,600 general practices across England registered with CQC.
How special measures could work for general practice
There are two possible ‘entry points’ for special measures.
- If CQC awards an overall rating of Inadequate to a GP practice following a comprehensive inspection, it will be placed straight into special measures. NHS England will work closely with the practice to support it to improve.
- Within six months, CQC will carry out another comprehensive inspection. If the overall rating remains Inadequate, CQC will begin proceedings to cancel its registration (i.e. issue a ‘notice of proposal’ to cancel registration).
- Within six months of this, CQC will carry out a final inspection. If the service is still Inadequate overall, CQC will cancel its registration (i.e. issue a ‘notice of decision’ to cancel registration). This will be subject to the usual representations process. NHS England will make sure that patients registered at the practice are able to continue to receive primary care.
- Following an inspection, if CQC awards at least one Inadequate rating to a general practice for a ‘key question’ or ‘population group’ then it will be given up to six months to make the necessary improvements before re-inspection.
- Following the re-inspection, if the general practice is still Inadequate for a ‘key question’ or ‘patient group’, it will then be placed into special measures. NHS England will work closely with the practice to support it to improve.
- Within six months, CQC will carry out another inspection. If a ‘key question’ or ‘population group’ rating(s) is still Inadequate, CQC will begin proceedings to cancel the practice’s registration (i.e. issue a ‘notice of proposal’ to cancel registration).
- Within six months of this, CQC will carry out a final inspection. If the ‘key question’ or ‘patient group’ rating(s) is still Inadequate, CQC will cancel its registration (i.e. issue a ‘notice of decision’ to cancel registration). This will be subject to the usual representations process. NHS England will make sure that patients registered at the practice are able to continue to receive primary care.