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Third of GP practices with problems fail basic standards

CQC checks show new GP inspection regime will be tough

Adrian O'Dowd

Thursday, 12 December 2013

Around a third of GP practices that have been identified as potentially having problems are failing to meet basic standards of care for their patients, concludes the CQC in its first report of practice inspections.

The regulator today published its report A fresh start for the regulation and inspection of GP practices and GP out-of-hours services in which it highlighted a minority of practices that were a cause for concern.

Since April of this year, the CQC has completed 1,000 practice inspections, including visits to 950 practices in England and then follow up visits where inspectors returned to check improvements had been made.

Although most people were receiving good quality care from their GP, the CQC said there were some examples of very poor care, with 34% failing at least one of the required standards, and in 10 practices there were very serious failings that could potentially affect thousands of people.

Problems included drugs being used that were out of date or stored on the floor and a lack of temperature checks of vaccine fridges.

Some practices were visibly dirty, had dirty cleaning equipment with no cleaning schedules, staff had no knowledge of infection control guidance and maggots were found in one practice.

In addition, practices were not always doing the necessary employment checks on staff who could have access to sensitive patient information and be in contact with vulnerable people.

The majority (80%) of the practices inspected were chosen either because they had declared themselves not to be compliant with all CQC standards when registering with the regulator earlier this year or because of information given to the CQC from CCGs or the GMC that had raised questions about potential risks at these practices.

The findings from the inspections will help the CQC’s chief inspector of general practice Professor Steve Field to develop his plans for changing the way CQC inspects general practices.

Professor Field said expert inspection teams that include GPs will be at the heart of a new style inspections that will start in April of next year.

Inspection teams will include a CQC inspector, a GP, a practice nurse or practice manager and a trainee GP. They may also include a member of the public.

The plan is to inspect practices from across a CCG area and for inspectors to visit every CCG area once every six months, inspecting a quarter of the practices in that area.

Every practice will have been inspected by April 2016 and the inspections will ask five key questions of services – are they safe, effective, caring, responsive to people’s needs and well led. GP services will be given ratings.

Professor Field said: “There are a minority of practices providing unacceptable care – it is essential that we shine a spotlight on these bad practices to make sure the care their patients receive improves and that we do this by regulating, monitoring and inspecting the sector in a robust and effective way.

“At the other end of the spectrum, we want to highlight good and outstanding practices and encourage improvement in GP surgeries across England.”

Dr Maureen Baker, chair of the RCGP, said: “Patients should expect high quality and consistent care from their GP practice, and the vast majority of practices do an excellent job of delivering quality care while maintaining the highest possible standards.

“Breaches of procedure cannot be condoned - even if they are isolated incidents - but the inspections were largely targeted at particular practices which had already been identified as having problems.”

Dr Chaand Nagpaul, chair of the BMA’s GP committee said: “While most patients receive high quality care from their GP, we need to understand where and why shortcomings in a small number of practices exist, and the BMA is committed to working with the chief inspector to improve standards.”

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