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CQC introduce a special measures framework for GP practices

Three GP practices have been placed in "special measures" as part of a new inspection regime from the Care Quality Commission.

23 January 2015

The report published yesterday said "significant areas of concern" had been uncovered at the surgeries in Liverpool, Reading and Greater Manchester.

In August 2014, the Care Quality Commission announced plans to introduce a special measures framework for GP practices.

The first results from the inspections have rated three GP practices as outstanding, 57 as good, 10 as requiring improvement and 5 as inadequate. Three GP surgeries have been placed in special measures.

Speaking about the findings Despina Kavadas, a lawyer in the Leigh Day medical negligence team, said: “We welcome any initiative which improves GP services. We act for clients of all ages who have received inadequate care from their general practitioners often leading to disastrous, disabling and/or fatal consequences.

“Through litigation our clients are able to obtain compensation, but litigation does not allow a Claimant to force a GP surgery to review its practice to ensure it does not provide inadequate care. In some instances settlement is reached without an admission of liability or an apology.

“We hope that the CQC’s initiative will benefit patients and GP practices by improving the standard of care patients receive and by providing the support GP practices need in order to deliver an appropriate and adequate standard of care.

The framework introduced in August by the CQC aims to identify those GP surgeries which are providing inadequate care.

The CQC and NHS England are working together within the framework to provide a timely and coordinated response to ensure that those GP practices, which are providing inadequate care, do not continue to do so.

If a GP practice, which is identified as providing inadequate care, does not improve the quality of care within the timeframe stipulated by the CQC, the CQC will seek to cancel their registration.

In October 2014, the CQC began piloting the framework. It began inspecting and rating NHS GP practices in one of four categories: outstanding, good, requires improvement or inadequate based on the extent that they were safe, effective, caring, responsive and well-led.

The inspections focused on six key population groups - older people, people with long term conditions, working age people; families, children and young people, people living in vulnerable circumstances and people with poor mental health.

As a result of the piloting in October 2014, the CQC identified the need to amend the criteria for a GP practice being put into special measures.

The CQC has now clarified that a GP practice with an overall rating of inadequate following the initial inspection will be placed straight into special measures.

However, if, following the initial inspection, only some aspects of the GP practice are rated as inadequate, it will have 6 months to improve and at the next inspection if the GP surgery has not improved, it will be put into special measures then.

In either case, the GP practice will usually be placed into special measures for 6 months. During that time it will have to improve its rating, failing which the CQC can take steps to cancel their registration.

NHS England and the Royal College of General Practitioners are developing arrangements to provide support to GP surgeries that are placed in special measures.

Any GP practice placed into special measures between 1 October 2014 and 30 June 2015, where NHS England does not enact contractual action, will be eligible to apply for this support.

It will provide a package of expert professional advice, support and peer mentoring from senior GPs, practice managers and nurse practitioners with specialist expertise in quality improvement coordinated by the RCGP. It will draw on insight and support from other local practices and professional leaders, including the LMC (Local Medical Committee) and CCG (Clinical Commissioning Group).

It is also important that patients are informed when a practice is rated inadequate or placed into special measures, what the rating means and what action the practice is taking to improve. 

NHS England recommend that these practices be supported by their area teams to inform their patients by including information in the waiting room, on the practice website and on the NHS Choices website, and in direct meetings with patients (such as the patient participation group).

Furthermore, action should be taken to ensure that the largest possible number of patients is made aware of the outcomes. For example, via notices on the Healthwatch, area team and CCG websites and other communication channels.  

In April 2015 the CQC will implement fully their final approach to special measures and will publish their final guidance on special measures before April 2015.

Information was correct at time of publishing. See terms and conditions for further details.

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