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200 GP practices could be closed, primary care inspector has warned

CQC inspection and special measures regime begin in earnest tomorrow

Caroline White

Tuesday, 30 September 2014

Around 200 general practices could be closed once the Ofsted-style inspection regime gets under way in earnest tomorrow, the chief inspector of general practice at the Care Quality Commission (CQC) has warned.

Commenting on a pre-recorded interview with Sky News, broadcast earlier today, Professor Steve Field, chief Inspector of General Practice, was at pains to point out that only a small number of practices were likely to give cause for concern.

But when pressed for figures during the interview, he suggested this could be around 200 out of a total of 8,000 practices in England.

“Where practices give cause for concern, the main priority is for those practices to improve and the new special measures regime is designed to direct practices to improvement and give them time to improve,” he said in a statement.

CQC tested out its new way of inspecting GP practices between April and June this year. The scheme includes GPs acting as special advisors on specialist inspection teams.

The 348 pilot inspections conducted so far confirm that most practices are providing high quality care, but a small number are providing very poor care, the CQC said.

Under the new 'special measures' regime, first announced in July, practices offering substandard care will be given 6 months to make improvements or face closure if they fail.

The regime will coincide with a new Ofsted-style rating scheme for GP practices in England on the basis of whether they are ‘outstanding,’ ‘good,’  ‘require improvement’ or ‘inadequate.’

Practices that fail to make improvements will be put into special measures, after which they will be given a further six months to meet the required standards. If still judged to be inadequate after this, their CQC registration will be cancelled and their contract with NHS England ended.

Professor Field emphasised: “General Practice is the jewel in our crown. Most GPs across the country are providing really good care despite rising demand and other problems such as old premises.

Unfortunately the majority are undermined by a small percentage of GPs who are not providing the care our patients deserve. CQC will shine a light on those poor practices but will also celebrate good and outstanding practices and encourage improvement.”
He added: “Everyone should be able to receive good quality care from their GP practice, whoever they are and wherever they live in England. Our new style inspections will help to celebrate and promote good practice and ensure that GP practices in need of further support are identified so that they are better able to meet the needs of their local communities.”
Dr Maureen Baker, Chair of the Royal College of General Practitioners, commented: “There is no excuse for poor care and action must be taken if practices are failing to provide decent standards of care to their patients.” 

“What the Care Quality Commission inspections are highlighting, however, are the growing pressures that GPs and their teams are currently facing in trying to deliver safe patient care with diminishing resources,” she said.

“If practices are struggling to meet quality standards due to factors beyond their control - such as lack of funding, significant increases in patient consultations and difficulties in trying to recruit sufficient GPs - we should not be ‘labelling’ them but looking at what support they need to bring them up to scratch,” she insisted.

Practice closures could have a knock-on effect on neighbouring practices so any such decisions would need to factor that in, she cautioned.

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