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Are New GP Inspection Plans A Step Too Far?
The most significant change this year to the way Practices are inspected by the CQC is that a GP, a specialist inspector and a nurse or practice manager will be part of every inspection. GP trainees and patients may also attend some inspections.
With the introduction of the new regulatory approach to inspect GP Practices it appears that the CQC inspection teams may sit in on some GP consultations as part of their visits. CQC told Pulse recently that this would form part of new methods of gathering evidence when inspecting GP practices and will feature as part of the pilot inspections that will run up until the formal launch in October.
Is this appropriate?
The initial response from GP organisations to this approach has understandably been quite negative, believing it’s the role of the GMC not the CQC to assess how a GP consults with his patients. Dr Robert Morley, head of the GPC contracts and regulation subcommittee said: ‘I personally feel it’s wholly inappropriate, regardless of patient consent. There is a world of difference between, for example, Ofsted sitting in on a teaching lesson and an inspector sitting in on that most confidential and intimate encounters, the consultation between a patient and their doctor.’
Could it affect the consultation?
When the CQC monitors, inspects and regulate GP practices they want to make sure they look at the things that matter to the people who use them and that their interests are at the heart of the five key questions the CQC asks about the quality and safety of GP practices and it seems this is the CQC’s latest approach to do this.
I know from personal experience that when someone watches over you whilst you work you are very conscious of their presence, often unable to relax and may make silly mistakes. It’s a good opportunity to show your abilities and skills, and to explain why you do what you do, but it can also make individuals feel defensive and none of us like such direct scrutiny.
Developing the new regulatory approach
The five key questions that CQC ask of GP Practices are:
- Are they safe?
- Are they effective?
- Are they caring?
- Are they responsive?
- Are they well-led?
The CQC admits that at the moment there is a lack of clarity about what good care looks like in general practice and their aim is to work much more closely with the public, people who use services, GPs and practice staff. Surely this new, perhaps intrusive approach will create resistance from GP’s and an even more stressful inspection experience for practices than is actually necessary?