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Poor CQC ratings linked to poor practice funding

NHS England must ensure funding uplift so all practices get same high level of support – BMA

Louise Prime

Tuesday, 17 May 2016

NHS England must ensure that GP practices receive an uplift in funding that results in every practice in England getting the same high level of support, the BMA has insisted after research revealed a strong link between practices’ level of funding and their Care Quality Commission (CQC) ratings. It said it was wrong to unfairly judge practices when they are not being properly resourced to provide good patient care.

The BMA compared the level of per-patient funding that practices in England received, with the most recent ratings that they were given by the CQC; its analysis covered 2,814 practices. The resulting report, published yesterday, showed that although the CQC doesn’t take into account practices’ resources when making inspections and publishing ratings for their performance, there is a clear link between funding and CQC ratings.

Overall, the BMA found that average funding per patient is higher in those practices with higher CQC ratings – per-patient funding tends to be higher for practices rated ‘outstanding’ or ‘good’, compared with those rated ‘requires improvement’ or ‘inadequate’. The report’s authors said: “Overall, whilst we cannot say with certainty that higher funding leads to improved performance (as rated by CQC), there appears to be a pattern whereby those practices with higher funding achieve better CQC ratings; ultimately practices that do not have adequate resources are penalised by low ratings.” They reported that:

  • GP practices receiving an ‘outstanding’ or ‘good’ rating from the CQC received, on average, £152 and £140 per patient in funding respectively;
  • GP practices that scored ‘inadequate’, in contrast, received on average just £128 per patient, and those marked as ‘needs improvement’ were allocated £111 per patient;
  • The average level of funding for GP practices across England is £141 per patient, placing it below the level of resources received by most GP practices who were given an ‘outstanding’ rating.

BMA GP committee chair Dr Chaand Nagpaul (pictured) said: “This analysis shows there is a clear link between the amount of funding a GP practice receives and the rating they are allocated by the CQC.

“Despite this, the CQC takes no account of resources available to a GP practice when they grade their care, even if this leads to GPs and their staff being publically shamed with an ‘inadequate’ or ‘needs improvement’ rating. This is wholly unfair given the obvious impact that funding has on the ability of GPs and staff to run their practices, and which will impact on the CQC’s own rating system. The research also demonstrates the wide disparity between funding for practices which is completely unacceptable.”

He went on: “NHS England needs to … ensure that GP practices receive an uplift in funding that results in every practice in England getting the same high level of support. We also need the current CQC assessment system to end and be replaced by a proportionate and fair alternative … GP practices must not be unfairly judged when they are not being given the tools they need to effectively run their practices to provide care to the public.”

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