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Who’s Right About Inspections: the BMA or CQC? Or Could They Both Be Right?

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Following on from our article about the extra costs being foisted on GP practices (GP Practices Lose Out in the Financial Battle between Government and CQC), it’s worth noting that the government are not the only people with whom the CQC are battling. At the end of January, the BMA weighed in with a report that concluded the CQC’s inspection system to be “disproportionate, onerous, and flawed.” The CQC responded by saying that it makes “no apology for acting in the best interests of patients, who tell us they want to know care services are safe, effective and responsive.”

As with any dispute, there are two sides to the argument.

What the BMA said

The BMA said that its CQC Inspection Survey was triggered by growing dissatisfaction among ‘grassroots GPs’. Its survey showed that:

- 80% of doctors find their available time with patients is disrupted by the inspection

- 70% complained of the cost of preparing for inspections (for example hiring new staff)

- 90% said they had to reduce services on inspection day

The BMA also reported that three quarters of staff suffered a significant uplift in stress levels while preparing for and during an inspection.

These are pretty damning findings.

What the CQC said

The CQC responded to the BMA report by saying that its inspections are valued by both patients and GPs. It surveyed GPs, and two thirds of those surveyed said that the inspection regime had helped them to improve. It also found that 76% of GP practices and out-of-hours services effectively used the inspection process to review the services they provide in the five key areas of inspection.

In its response it pointed to the 90% rate of improvement of re-inspected practices, and how sharing of best practices had enabled improvement of safe service delivery. It also said that patient calls received on its helpline evidence that patients believe the CQC inspection regime adds value by highlighting what is going wrong at GP practices.

The CQC’s rebuttal certainly does have valid reasoning.

Is there a reasonable way forward?

Perhaps, rather than taking potshots at each other, the CQC and BMA would do well to work more closely together to offer suggestions to resolve these issues. After all, the aim of the CQC is to ensure that services provided to patients is as good as it can possibly be. And I haven’t met a single doctor who doesn’t want the same.

How the GP practice can reduce the stress and cost of CQC Inspections

The BMA GP committee chair, Dr Chaand Nagpaul, acknowledged that GP services must be properly assessed, but said that, “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.”

So we have a situation where both GP Practices and the CQC want to ensure that service provision is continually improving, and the BMA agree that assessment is needed to ensure that GP practices are providing the level of service that patients should.

Here’s a bold suggestion:

Instead of GP practices being encouraged to act like pre-exam students and swatting up in the two weeks before an exam, shouldn’t improvement and maintenance of service provision be a continual aim? If this were the case, then wouldn’t the costs and stress of assessment day be reduced?

And instead of the CQC conducting a mega, end-of-term make-or-break exam, wouldn’t it be better to assess in smaller, bite-sized and manageable chunks? Wouldn’t continuous improvement be better measured continuously, rather than once every year or two years?

Perhaps if the BMA and CQC could work with each other, and take on board the views of GP practices and their patients instead of using them to try to point score, then the needs of both GP practices and patients would be met more easily.

After all, the views of the BMA and CQC are two sides of the same coin. All we need to find is how to flip the coin for it to land on its edge.


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If you have any questions or feedback, please do not hesitate to contact me -alex.henman@esuppliesmedical.co.uk - 01865 261451

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