The first new OFTSTED-style assessment of all 7,661 GP surgeries in England by the Care Quality Commission (CQC) has found up to one in six may not be giving patients the high-level of care they expect.
Among the areas of concern are patients having difficulty getting an appointment, a lack of practice nurses and some being given medicine which is out of date. Not enough older people being given the flu jab was also highlighted as a problem. Most are looking after their patients well though, the CQC said, but up to 1,200 practices face being assessed again under its tough new guidelines.
The CQC, which is the independent regulator of health and social care in England, used 38 key indicators to assess whether doctors were placing their patients at risk. Each surgery was then given a rating and assigned to a band from one to six, with one being the highest level of concern. Of almost 8,000 surveyed, 1,200 were placed in bands one and two meaning they will be inspected fully by the CQC in 2015. 864 were classed as being of the “highest concern.” 3,797 were put in band six, and 6,076 in total filled the top four bandings. The regulator created the bandings based on “intelligent monitoring” which takes into account a number of factors including surveys, official statistics and patient experience.
Other criteria include detection rates for diseases like cancer and dementia, opening hours and the number of elderly patients who end up in A&E as they have not been properly looked after by their surgery.
Chief inspector of the CQC Professor Steve Field, who is also a GP, said the characteristics of “poor practices” are “very poor leadership and a lack of learning culture” together with a lack of nurses.
Poorly-performing practices will receive an official inspection, consisting of thorough, day-long spot-checks over the next few years, and those who don’t make significant improvements could be closed down.
While the report was welcomed by the Patients Association, whose chief executive Katherine Murphy said she hoped it would act as a catalyst for GP practices which needed to improve to do so, the British Medical Association feel it is too “simplistic, potentially misleading and confusing to patients.”
Dr Richard Vautrey, chairman of the BMA, said: “It will not give an accurate picture of how GP services are operating. The information does not take into account the differing circumstances GP practices operate in, including levels of deprivation in the community they deliver care to or the state of their facilities.”
The report also said patients could help by paying better attention to their health and going to the pharmacy for medicine rather than their GP if they feel unwell.
Surgery ratings can be found at http://www.cqc.org.uk/content/our-intelligent-monitoring-gp-practices. Searches are conducted by postcode or surgery name.
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