Two of the most powerful bodies representing the country’s GP workforce have called for an emergency suspension of health watchdog the Care Quality Commission’s (CQC) inspections of their surgeries.
The extraordinary call, made independently by doctors’ union the British Medical Association (BMA) and the professional body the Royal College of General Practitioners (RCGP), reflects widespread discontent within the profession at an inspection regime which has been seen to be unfair on surgeries, while diverting scarce time and resources away from patient care.
In a letter to the Health Secretary Jeremy Hunt, the RCGP warned that GP services could go into the “meltdown” within six months if some of the pressure was not taken of surgeries. Dr Maureen Baker, chair of the RCGP, said that strains on family doctors – who are losing hundreds of experienced hands to retirement, while struggling to recruit new trainees – had now reached “such an extent that they are giving rise to serious patient safety concerns”.
Meanwhile, the BMA has voted in favour of a motion declaring the CQC, which inspects healthcare organisations throughout England, “not fit for purpose”. Doctors gathered in Liverpool for the union’s annual conference have even called for the watchdog to be “decommissioned” and its funding “reinvested in frontline care”.
Family doctors have had longstanding concerns about the CQC’s inspection regime, which was overhauled during the last Parliament as part of Jeremy Hunt’s renewed focus on patient safety within the NHS.
However, trust between GPs and the CQC suffered a major blow at the end of last year when the watchdog, prior to inspections, banded practices into six categories according to patient safety risk. The bandings were made public, with 1,200 surgeries placed in the highest risk categories. Sixty of these were later removed after the CQC reviewed its methodology, before the banding system was scrapped altogether in March.
Dr Chaand Nagpaul, chair of the BMA’s GP committee, said that the inspectorate had “lost the confidence of the profession”, accusing its assessments of being “overly bureaucratic and often nit-picking”, while wasting time that GPs could be spending with patients. The cost of the inspectorate had spiralled to hundreds of millions of pounds annually, he said.
“Many of the inspection reports are of questionable clinical value and are presented in simplistic, crude terms that tell patients little about the quality of care being provided by their practice,” he said. “Even worse they have the potential to mislead the public and do not encourage on-going quality improvement.”
In the wake of the vote against the CQC, the BMA is seeking an urgent meeting with the Government and the watchdog to agree a suspension of the current inspection process.
The union’s revolt comes after the governing council of the RCGP, which represents 50,000 family doctors, unanimously agreed an emergency motion calling for “an immediate pause in the CQC’s programme of routine inspections in order for practices to better manage their workloads.”
Dr Baker’s letter to Mr Hunt said: “We believe that the time has come to conduct an urgent review of the CQC’s regulatory regime, to eliminate unnecessary bureaucracy and to ensure that it reflects the distinctive nature of general practice and focuses on what matters most to patients.
“Whilst this takes place, we call for the CQC’s programme of routine inspections to be halted on a temporary basis, as a means of alleviating the pressures on general practice which have now reached such an extent that they are giving rise to serious patient safety concerns.”
Warning that GP services are already “on the brink of meltdown” as the ageing GP workforce attempts to cope with ever-rising patient demand, Dr Baker also calls on Mr Hunt to drop Government plans for universal seven-day access to GPs.
“Our members are extremely concerned about the impact such a move would have on their ability to keep vital services up and running for patients,” she writes. “In the current climate – with huge concerns about current and future workforce capacity, and experienced GPs retiring due to high stress levels – we believe it is unrealistic to talk about achieving seven day access for routine GP care.”
Professor Steve Field, the CQC's chief inspector of general practice, said the organisation was "extremely disappointed" by the RCGP's call.
So far, around 85% of general practices inspected have been rated either Good or Outstanding, he said.
"However, when over 1 in 7 general practices are not delivering the care that patients have every right to expect, now is not the time for us to put a halt on our inspections," he added.
Health Secretary Jeremy Hunt said: "We make absolutely no apology for giving the public clear information for the first time on the quality of their local GP services, or for ensuring that hardworking families can access a GP 7 days a week.
"To halt inspections now would be a big mistake, and slow down the process of improvement for those surgeries which aren’t giving the public the high standards of care they deserve."Reuse content