Last month GPs shared grim experiences of ‘aggressive’ CQC inspections, with clinicians revealing that staff had overdosed on medication before being assessed due to nerves; another accused inspectors of being ‘racist and sexist’.
The watchdog made clear at the time that it viewed ‘unprofessional behaviour or discrimination of any kind’ as unacceptable.
It has recently published a consultation document outlining proposed changes to inspections, including less frequent assessments and a simplified ratings system. It has also announced plans to investigate ‘longstanding concerns’ that black, Asian and minority ethnic (BAME) GP partners may be more likely to score lower in practice ratings.
But BMA chair Dr Chaand Nagpaul 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.
The BMA and RCGP have previously called for a major rethink on CQC inspections following the coronavirus pandemic – insisting a return to business as usual would be a mistake.
Responding to suggestions from Nottingham GP Dr Shan Hussain that a new, evidence-based inspections model should be introduced, Dr Nagpaul said: ‘I agree we must end CQC inspections & replace [them] with [an] proportionate, supportive, improvement-based approach.
‘I’m leading BMA work, comparing regulation in the four UK nations and none adopt CQC inspections that divert time away from patient care [and] instil fear and non-contextual judgment’.
Agree we must end CQC inspections & replace with proportionate, supportive, improvement based approach. I’m leading @TheBMA work comparing regulation in 4 UK nations & none adopt CQC inspections that divert time away from patient care & instil fear and non-contextual judgement. pic.twitter.com/rjyLxY0xqR
— Chaand Nagpaul (@CNagpaul) May 6, 2021
The BMA chair also shared an image of a survey which showed that 93% of GPs thought inspections diverted time and resources away from patients, while 86% feared inspections.
In another response he said: ‘CQC inspections in general practice are often counterproductive and bureaucratic. There are other models of effective regulation in other nations that are supportive, effective and facilitate improvement.’
Newham GP Dr Farzana Hussain also highlighted problems with the current CQC inspection model via Twitter. She said: ‘BAME GPs tend to work in small practices and be single handed and work in deprived areas.
‘The inspection model and incentives are geared towards larger practices in affluent areas. The quality of care provided such as personalised continuous care is often overlooked.’
Important insight: BAME GPs tend to work in small practices & be single handed & work in deprived areas. The inspection model & incentives are geared towards larger practices in affluent areas. The quality of care provided such as personalised continuous care is often overlooked https://t.co/BoId08Z2lo
— Farzana Hussain (@fhussain73) May 4, 2021
In 2019, the GMC’s Fair to Refer report found that BAME GP partners were more likely to receive lower ratings following CQC inspections; something that has since been acknoweldged by the CQC.
Responding to the comments, chief inspector of primary medical services at the CQC Dr Rosie Benneyworth said: ‘The pandemic is continuing to have a huge impact on practice teams as they deal with the demands and pressures of providing care in the face of challenging and changing circumstances.
‘We remain committed to minimising the impact that regulation has on providers and to working with them as partners with a shared goal of good outcomes for people who use services.’
She added: ‘The proposals in our recent consultations are based on conversations and feedback that we have from speaking with GPs and practice teams, people who use services and our inspectors. People look to CQC for assurances about the care they can expect, and we think these proposals on flexible and responsive regulation will continue to offer this.’
Last June the BMA, along with the RCGP argued that reduced regulation during the outbreak had made general practice ‘doable’ again – requesting a rethink around inspections. Meanwhile, two thirds of GPs told a GPonline poll that scrapping CQC inspections would not affect 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’.