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CQC regime is ‘damaging’ patient care, says survey

87% of practices say inspections mean less time for patients

Adrian O'Dowd

Monday, 01 February 2016

The current inspection regime of general practices by regulator the Care Quality Commission (CQC) damages patient care and forces doctors to divert resources away from patients, according to a survey released at the weekend.

The BMA survey of more than 1,900 GP practices in England contained a high level of criticism towards the CQC’s approach, saying it was disproportionate, burdensome, flawed and costly in terms of time for patients and locum cover.

The CQQ, however, said its inspections were crucial to ensure patient care was safe and effective, and sometimes involved telling “uncomfortable truths”.

Growing feedback from grassroots GPs about the impact of the CQC’s inspection regime on patient care in general practice prompted the union to carry out the survey, said the BMA.

Its survey found that 80% of GP practices reported that preparing for a CQC inspection resulted in a reduction in time available to care for patients.

Seven out of ten (70%) of practices had to spend funding on staff overtime while preparing for the inspections, while 30% had to employ locums.

The vast majority (87%) said that on the day of the CQC inspection, staff had to reduce GP services available for patients, with 76% reporting a loss of nursing time.

Three quarters of GP practices (75%) reported that staff suffered from significantly increased stress in preparing for and undergoing inspections, while 74% of GPs felt the inspection regime could make them more likely to leave general practice.

During the BMA’s special LMC conference held in London on Saturday, GPs in the audience voted overwhelmingly for a motion calling on the union’s GP committee to campaign for general practice inspection by the CQC to be abolished and replaced with a peer-led quality assurance scheme.

Dr Chaand Nagpaul, BMA GP committee chair, said: “This survey demonstrates the damaging, negative impact that the CQC’s failing inspection programme is having on patient care in general practice.

“GPs are being forced to divert valuable time away from treating patients towards the endless box ticking, paperwork and bureaucracy that is the hall mark of this programme.

“Vital NHS resources are being wasted on employing locums and staff to cover the work of a GP practice in the run up to and while the CQC is in the building.

“The current CQC inspection regime is not fit for purpose, and needs wholesale reform that produces an effective, slimmed down process focusing on ensuring a safe, effective service for patients.”

A spokeswoman for the CQC defended the regulator’s approach, saying: “We make no apology for acting in the best interests of patients, who tell us they want to know care services are safe, effective and responsive.

“Not only do patients value our inspections, but GPs themselves have told us inspection has helped drive improvement (nearly two thirds of those surveyed). We’ve also found over three quarters (76%) of GP practices and out-of-hours services agreed their inspection provided a thorough review of whether they were safe, effective, caring, responsive and well led.

“We’ve worked hard to ensure that the inspection of GP surgeries does not impact adversely on the practice being able to provide patient care by working with practice staff to design the agenda for that day.

“There can be no improvement without genuine transparency. Sometimes this will involve telling uncomfortable truths.”

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