The Care Quality Commission (CQC) will not launch an inquiry into its process for inspecting GP practices, despite 145 GP practices calling for one in an open letter.

In March, the Doctor’s Association UK (DAUK) published an open letter to the Commission calling for a ‘full enquiry and overhaul of the CQC inspection process’, after some ‘aggressive and unreasonable’ inspections had taken place.

In a response dated 28 June, CQC’s chief inspector for primary care, Dr Rosie Benneyworth, said that ‘bullying and harassment is unacceptable in all circumstances’ and that her ‘expectation is that CQC inspectors act professionally at all times’.

However, the letter did not address the call for a full inquiry.

Dr Benneyworth instead said that the CQC’s new monitoring approach, which was developed during the pandemic and published earlier this month, reflects ‘the pressure providers are under’ and will remain in place.

She added that she is ‘keen to continue to develop’ the CQC’s regulatory approach for general practice – in line with the aims set out in its new strategy – so that it is ‘proportionate’ and ‘helps ensure people receive safe and effective care’.

Management in Practice reported earlier this month that the CQC’s new monitoring approach set out its plan to begin ‘sampling’ services and carrying out monthly risk reviews.

A CQC spokesperson told Management in Practice: ‘While we do not intend to launch an inquiry, work has already been carried out to review our approach across all sectors, which has changed from how things operated before the pandemic. 

‘We are committed to continuous improvement and review of our processes, involving people who work in and use services along the way.’

The CQC has invited DAUK representatives to ‘discuss their concerns in person’.

Inspections ‘aggressive and unreasonable’

In its March letter, the DAUK said the CQC’s decision to resume inspections was ‘unfortunate and unacceptable’, and that they had been conducted ‘in an aggressive and unreasonable manner that can no longer be tolerated’.

It called for a ‘simplified’ and ‘evidence-based’ approach to the inspections grounded in ‘mutual respect, understanding, collaboration’ and support.

It suggested CQC inspections be reduced in frequency unless there have been concerns within the previous three to five years, and for inspections to be suspended for the duration of the pandemic.

It also said that GP teams were aware of reports that the CQC has issued threats of practice closures and fines, which have heaped ‘undue pressure on colleagues’.

It added that many practices feel ‘unable to air their grievances’ over the CQC inspection process, which can take ‘days or weeks’ to prepare for.

The 145 signatories called for a ‘full investigation into such practices and behaviours’, adding that the NHS has a ‘zero tolerance policy’ to bullying and harassment, and that they ‘demand that CQC respect our position’.

CQC inspections of services that had previously breached regulations, as well as those rated as ‘requires improvement’ without any regulatory breaches, resumed in April 2021, after routine inspections were paused in March 2020.

Read the full article here.

Dear Ian Trenholm,

We are writing to you regarding the resumption of CQC inspections for GP surgeries across the country. On March 16 , the CQC announced that annual inspections would be paused in light of the pandemic, a decision that was welcomed by several GP groups including the RCGP.

Primary care is under a huge deal of strain at the moment. The recruitment, retention and workforce issues which pre-date the global COVID-19 pandemic are still present. On top of that GP surgeries have had to deal with an almost overnight shift into new remote ways of working, managing rising workloads and patient demand, dealing with the backlog of patients from secondary care who have been lost to follow-up or had routine outpatient treatment delayed.

We were therefore dismayed to note inspections were resumed as early as July. Our concerns are now growing as we are now well into the throes of the second wave of the pandemic, and trying to roll out the largest ever vaccine campaign, of a new novel vaccine, in the hardest winter the NHS has ever seen, as well as provide routine work.

To expect colleagues to then face the additional stress and added administrative burden of a CQC inspection is unrealistic and provides GPs with none of the support or morale boost that they need, having worked above and beyond for the last nine months during this pandemic.

It is shocking to us to hear that our colleagues are not only shouldering these compounded stressors, but that in some cases it has led to them becoming physically unwell as a result. We have just been contacted regarding a GP working in Kent, who was rushed to hospital with acute chest pain following an incredibly stressful CQC inspection. During such unprecedented times when we are not only working to keep our patients safe, but seeing colleagues around us fall ill and succumb to COVID-19, it is difficult to see how the commencement of such inspections is justified.

This betrays a lack of trust in GPs, and is not what it is needed right now. As we rely on primary care to successfully lead us through a novel vaccination campaign larger than any the NHS has ever seen, the government and regulatory bodies need to put their faith and trust in primary care, and expecting inspections to go on whilst GPs are juggling these additional stressful factors simply does not relay a message of confidence in primary care.

We recognise that inspection and regulation is a vitally important part of ensuring good standards of care across the nation, however we feel that these processes need to resume outside of a global pandemic. Unprecedented times require an unprecedented approach.

We therefore call on you to halt and delay CQC inspections until such time as the healthcare system is back to its normal function, and GPs are better able to evidence the consistent quality of care they have been providing during this time.

Yours sincerely,

The Doctors’ Association UK GP Committee