GP practices providing ‘inadequate’ care will be given improvement deadlines or face potential closure under a new system of’ special measures’ introduced by the Care Quality Commission (CQC).
The regulator will introduce the new measures from October, according to a report by the National Health Executive. This will coincide with the time it starts to rate 8,000 NHS GP practices on the basis of whether they are outstanding; good; requires improvement or inadequate.
Under the new proposals, where aspects of a service are rated ‘inadequate’, practices will have six months to improve. If they fail to improve they will be put into special measures and if after a maximum of a further six months they are still found to be inadequate, they will have their registration with the CQC cancelled and/or their contract terminated by NHS England.
The CQC added that it will initially pilot the special measures regime to test its approach, working with NHS England. It will also work closely with the General Medical Council (GMC), the Royal College of GPs (RCGP) and others to develop special measures.
The new measures bring GP practices into line with other sectors regulated by the CQC, and when inspecting providers it will ask five key questions about practices and services, are they: Safe? Effective? Caring? Responsive to people’s needs? And Well-led?
Inspections of GP services will also look at how well services are provided for specific groups of people and what good care looks like for them.
The groups are (subject to the outcome of a recent consultation):
- Older people;
- People with long-term conditions;
- Mothers, babies, children and young people;
- Working-age people and those recently retired;
- People in vulnerable circumstances, including people with learning disabilities; and
- People experiencing poor mental health and people with dementia.
Professor Steve Field, chief inspector of General Practice at the CQC, said: “Most GP practices provide good care. We have confirmed this in our pilot inspections so far. But we can’t allow those that provide poor care to continue to let their patients have an inadequate service.
“Special measures will firstly promote improvement, but where practices do not improve, working with NHS England we will call time on poor care. Special measures will be viewed as the final chance for a practice to improve.”
If a GP provider fails to improve after being placed in special measures there will be joint planning between the CQC and NHS England to ensure that patients registered at the practice continue to receive GP services, it has been confirmed.
But NHS England and the RCGP are developing arrangements to provide support to GP practices that are placed in special measures.
In response to the news, the RCGP said it welcomed the opportunity to play a significant role in supporting GPs and practices to deliver the best care they possibly can to their patients. But it will have no involvement in the inspection process or in making judgments about the work of individual practices.
Dr Maureen Baker, RCGP chair, said: “We are already campaigning to address the challenges faced by GPs in trying to care for patients against an increasingly difficult backdrop of diminishing budgets and workforce numbers.
“Our involvement will also ensure that the so-called ‘special measures’ do not become another stick with which to beat hardworking GPs, and that they do not damage patient care by increasing the already unrealistic workloads of GPs who are doing their absolute best to meet patient needs.”
General practice currently accounts for 90% of all patient contacts in the NHS, and family doctors are carrying out 340 million consultations a year – 40 million more than five years ago.