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BMACQCFebruary 3 2016

Inspection of general practices under the system currently used by the Care Quality Commission is diverting resources away from patient care, the BMA has warned.

Basing its arguments on survey responses from over 1,900 GP practices in England, the BMA has said the CQC inspection system is “disproportionate, onerous and flawed”.

Its survey findings included:

  • 80% of GP practices reported that preparing for a CQC inspection resulted in a reduction in time available to care for patients;
  • 70% had to spend funding on staff overtime while preparing for the inspections, while 30% had to employ locums;
  • 87% said that on the day of the CQC inspection, staff had to reduce GP services available for patients, with almost 67% reporting a loss of nursing time;
  • 75% reported that staff suffered from significantly increased stress in preparing for and undergoing inspections – less than 2% reported no impact on stress levels or a decrease;
  • 74% felt the inspection regime could make them more likely to leave general practice;
  • only 11% regarded their final CQC rating as a fair assessment.

Ahead of addressing the Special Local Medical Committee conference at the weekend, BMA GP committee chair Dr Chaand Nagpaul 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. These findings come at a time when the CQC is proposing unacceptable and extortionate rises in their fees which will pull even more resources away from frontline services.”

He acknowledged that GP services must be properly assessed to reassure the public. “However, the current system is disproportionate, onerous and flawed,” he said. “It is unacceptable that precious resources and time is being taken away from patient care when general practice is under unprecedented pressure from soaring patient demand, falling resources, staff shortages and un-resourced work being moved from hospitals into the community.”

One of the motions discussed at the Conference proposed that the current CQC inspection regime is not fit for purpose, and requires “wholesale reform” to produce “an effective, slimmed down process focusing on ensuring a safe, effective service for patients.”

The CQC issued a statement in response, 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. The feedback we’ve received indicates that surgeries already performing well do not find the preparation for inspection arduous, as the BMA suggests.

“Refusing to acknowledge problems and blaming those who expose concerns neither supports the profession or protects patients. There can be no improvement without genuine transparency. Sometimes this will involve telling uncomfortable truths.”

Links:

BMA announcement

BMA survey

CQC response

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