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Reforming CQC inspection model key to improving patient safety, BMA chair warns

By 27/05/2021No Comments

The new strategy, which follows a consultation process involving the public, health providers and partners, includes a focus on ‘smarter regulation’ – putting less emphasis on ‘a set schedule of inspections’ and favouring a ‘more flexible, targeted approach’.

Better data collection, which ‘reduces duplication and workload’ for services, will also help practices to improve their services and make them safer; something that will be implemented from ‘the point of registration’, the plan says.

However, BMA chiar Dr Chaand Nagpaul said that while the strategy is a move in the ‘right direction’, the CQC needs to adapt its inspection model to ‘identify specific areas of improvement’ for practices that ‘facilitate support for positive change’.

CQC inspections

Dr Nagpaul has also argued that the regulator must recognise how ‘vastly understaffed and under-resourced’ NHS services are when conducting assessments. He added no mention of staff wellbeing in the strategy was ‘disappointing’.

The CQC states in its strategy document that it wants to develop an ‘open and honest culture’, where staff can ‘feel confident’ that their concerns will be listened to and acted upon ‘quickly’. It also says that its regulation will be driven by people’s ‘needs and experiences’ – making it easier for people to give feedback.

Responding to the publication of the strategy, CQC chief executive Ian Trenholm said: ‘Our purpose has never been clearer. In our assessments we will ensure that services actively take into account people’s rights and their unique perspectives on what matters to them.

‘We will use our powers proportionately and act quickly where improvement is needed, whilst also ensuring we shine a positive light on the majority of providers who are setting high standards and delivering great care.’

Patient safety

But Dr Nagpaul warned that patient safety would not improve until the inpsection model was improved. He said: ‘The BMA has raised concerns about the way the CQC operates, the negative impact that inspections have on staff and patient services, and ultimately, whether its approach is effective or even counterproductive in achieving its aim, which is about improving patient safety.

‘Doctors have repeatedly told us how CQC inspections take significant time and resources away from direct patient care; that they are a poor measure of the quality of care delivered and that the aggregate rating system is crude and unfairly judgmental – failing to take into account the context of individual providers such as workload pressures, staff shortages or extenuating circumstances.

‘While this strategy is moving in the right direction, to really improve patient safety CQC must reconsider its crude rating system of inspection – which does not occur in any other UK nation.’

He added: ‘Only by recognising and addressing the wider pressures, and the incredibly difficult circumstances doctors and their colleagues find themselves working in, can we make positive changes that benefit patients and staff alike.’

Practice ratings

Earlier this month the BMA chair called for the current inspection system to be scrapped and substituted for one that would better support clinicians amid increasing workload pressures on GP teams.

Close to three quarters of respondents to the BMA’s member survey in 2018 said that CQC inspections added to fear and worry amongst staff in the workplace, while one in eight doctors said that they diverted time and resources away from patient care.

An opinion poll by GPonline last August found that around two thirds of GPs believe scrapping revalidation and CQC inspections would make no difference to patient safety. 

More recently dozens of GPs called for an investigation into the CQC’s approach to practice inspections as they argued that current methods used by the watchdog had created a ‘culture of fear’.

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