Care Quality Commission to Review GP Special Measures Scheme

The Care Quality Commission has signalled its intention to review the way that its GP special measures scheme operates.

Poorly-performing practices will be dealt with in what the commission describes as a ‘lighter touch’ inspection model from October.

The scheme provides a framework and timeframe for inadequate practices to improve, but is set to be axed under new plans documented by the Care Quality Commission.

A spokesman indicated that the commission is presently investigating how it should ensure that practices considered inadequate and requiring improvement can upgrade their operations.

NHS England had already announced that the support scheme, run by the Royal College of General Practitioners, currently intended to assist those practices placed under special measures, will also be scrapped when the new scheme is finalised.

Around 40% of premises placed in special measures later close down according to official figures, although the majority do demonstrate notable improvements within a small matter of time.

GPC deputy chairman Dr Richard Vautrey believes that the special measures label is ‘judgemental’, and instead suggested a more collaborative unsupportive process would be preferable.

“It’s about working alongside practices that makes the difference, it’s best to be supportive. There’s a variety of things – issues with premises, lack of investment, patient demographics – that the simplistic rating scale doesn’t reflect. We need the right support systems in place.”

New changes are intended to reduce the burden of regulation on GPs while ensuring high-quality care.

And the alterations to the way that the Care Quality Commission operates follows hot on the heels of changes already made to the hospital and adult social care systems, which already came into effect this month.

In order to improve processes in the health care system, the Care Quality Commission has confirmed that inadequate practices will be inspected again within six months of the initial rating being finalised.

The intention is for the commission to shift to a largely risk-based model, with the frequency and scope of inspections dictated by previous ratings and ongoing monitoring data.

Surprise inspections have already been included in the system, but these will become more prevalent as procedures evolve.

Commenting on the issue, a spokesman on behalf of the Care Quality Commission indicated that the processes would help improve the quality of services being proffered to NHS patients.

“We will be considering how we ensure services continue to improve, particularly those rated inadequate and requires improvement. The special measures guidance is being reviewed to make sure we can take necessary action when services fail to improve, but I can’t say what that will look like at this point.”

While the aforementioned Vautrey outlined the concerns that the General Practitioners Committee has about the way the Care Quality Commission operates.

“We’ve raised concerns from the outset that the four-point scale rating system is far too simplistic and isn’t helpful. It’s unhelpful to label practices as ‘special measures’, it becomes a judgemental process. What needs to be done is a recognition that these practices often get into difficult due to no fault of their own or long-term issues that haven’t been given support.”


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