Guest post by Practice Manager Nicola Hayward.
This has got to be the mother of all rants possible… if I say those three little letters C, Q and C, do your hackles automatically rise? Does your blood pressure go up by 100? Does that vein in your neck start to pulsate with rage?!
I’ve read this week about the ‘proposed’ fee increases and their consultation as to whether they claw money from us over a two year or four year period; this is no consultation, this is a fait accompli my friends! There’s no debate about the fees rise, just how long they’re going to take to grab it off us.
Looking at the website, I see as a three site practice, I will have to find the princely sum of just under £12,000 to pay for the privilege of CQC visiting me. Now, that rise is almost 600% on this year’s fee – and for what? According to their blurb, CQC has to change its fees “in order to be regulated”…and is necessary “for regulators to recover their chargeable costs” … err… why?! It goes on to say that their commitment “is to make sure that people receive safe, effective, compassionate and high quality care” and the fees paid “enables this important work to happen”. Does the amount of money we pay to CQC affect the way we care for patients? Of course it flippin’ well doesn’t!
I expect my mechanic to look after my car in a safe and effective way (and I’m hoping he’s high quality!) but if his charges rose by 600% I’d be taking my business elsewhere. Now that £12k could be the equivalent of a receptionist, or a part time dispenser. Some surgeries, in a rather precarious financial position, might have to consider what’s happening in the future – will they have to close a branch site? Will they have to let someone go? And if we do that, well doesn’t that impact on “safe, effective, compassionate and high quality care”? Of course it bloomin’ well does! How can you provide a service that meets the needs of ALL of your patients, if you’ve had to close half of your practice to enable you to pay a reduced fee?!
It’s not just fees for surgeries with branch sites that have gone up 600%, it’s everyone’s. Do the chaps at the top not read the newspapers? Are they not aware that primary care is in crisis? Is this part of a secret ploy by Jeremy Hunt to privatise the NHS by stealth? He’ll be OK – I’m sure there’s a private health plan for MPs to access – heaven forfend that they should find themselves in a mixed ward post-appendicectomy!
So, what’s the answer peeps? Well, seriously, I’m getting my head around a petition for us PMs to sign to say back off our NHS, stick your charges up the final section of your gastrointestinal tract and do one – BUT, we ALL need to be of one mind. If every practice in the country said NO, we ain’t paying, well, they couldn’t close us all down now could they?! BUT we all need to be behind this – and we all need to grow a set, use our spine and once and for all, tell his Royal Dipstick that we cannot go on like this.
Personally, if this carries on, I give the NHS five years – GPs will try and do their best for their patients but they are being hit at every angle, and it’s up to us to try and keep them afloat. But as more and more junior doctors decide not to go into primary care, we’re left with the golden oldies who are looking to retire, so won’t fight anyway, and the bunch in the middle who may decide to locum or look elsewhere for work – who needs the added stress?
So, chaps – what d’ya think?
Are you with me?
Nicola Hayward
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UPDATE on 19/11/2015: You can now sign the petition by clicking here.
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November 13, 2015 at 8:33 am
Hi Nicola,
I think you summed up my immediate thoughts exactly, its a big ask when most of us PM’s are generally worn down with the current struggle to keep things afloat. That said I will happily throw my hat in the ring to assist in raising the noise.
November 13, 2015 at 8:42 am
Abso-blooming-lutely!!!!!
Get it set up
November 13, 2015 at 9:12 am
Yes, I’d love to see this.
November 13, 2015 at 9:31 am
Yes I will sign it.
As it is always said ‘those that can do – those that cannot go into…in this case CQC.
Do they care – no. They have just closed a practice here, Section 30, with no thought about where the 5000+ patients are going to go……. the local practices here are already overloaded…….and the other rant in this instance is that NHS England also do not give a fig……Rant over but thanks for letting me get this off my chest…….
November 13, 2015 at 9:48 am
I must say I disagree completely those lovely people at CQC deserve even more to make sure we are well regulated and inspected. PS not been done yet!
November 13, 2015 at 9:50 am
Count me in too! When you also add in the fact they inspect every two or three years – total cost to the practice for their inspection is 2 or 3 years fees. Most years you will be paying for nothing except registration with them.
I bumped into an old friend last night, he used to work for the CQC as an inspector of care homes, he has now left them as he said ‘it used to be about caring for people, now its about finding fault and interogating’. He couldn’t put up with working like that!
November 13, 2015 at 10:36 am
Absolutely up for this. The constant ‘hoop-jumping’ is onerous enough without being charged even more for it 🙁
November 13, 2015 at 11:01 am
Absolutely, 36 years of constant change in the NHS and now a huge cost for the privilege of being inspected – I don’t think so!! I’ll sign.
November 13, 2015 at 11:42 am
Count me in!!!
The original concept was that CQC would help to standardise and improve quality -especially for those struggling practices, but listening and reading about some inspections, it seems that we have invented our own Gestapo in some instances!! And of course we have to pay for that priveledge, now in increasing amounts!
November 13, 2015 at 12:48 pm
Hi Nicola
I am with you all the way.
Gul
November 13, 2015 at 1:00 pm
YES!
November 13, 2015 at 5:27 pm
Hi Nicola.
I agree with everything and will support the cause, uprising, revolt, mutiny.
I must say on a Friday afternoon feeling a bit jaded I read your rant and loved it , so true and really did LOL at the line
“stick your charges up the final section of your gastrointestinal tract” – classic.
Give up your PM job and go into writing comedy- Nicola you would be famous overnight.
Best Wishes (look forward to your next rant)
Julie
November 14, 2015 at 5:51 pm
Good for you! I agree.
November 15, 2015 at 10:32 pm
Go for it Nicola! – I have just completed a post visit questionnaire and I didn’t hold back on telling CQC what an absolute load of rubbish it was and that we have not changed one thing since their visit – our patient care is already second to none so why would we want to.
I also agree that finances are under huge pressure and spending more on CQC fees will mean taking services away from the patients … where’s the sense in that?
Just show me where to sign – I’m feeling very militant about it!
November 16, 2015 at 10:05 am
In total agreement. Personally, my answer to all this increasing bureaucracy and destruction of primary care is to plan to retire 3 years before I ever wanted to. If I don’t I will make myself ill. Stress level is through the roof.
November 16, 2015 at 10:59 am
I am in, I have actually ran a care home and been inspected under that guise and I can tell you now that they require more from the CQC than General Practice ever will, therefore, they should pay for it! Private business is getting a reduction whilst government funded GP’s pay again!
I would be happy to help in whatever way I can.
Claire
November 16, 2015 at 2:26 pm
Count me in too, what happened to providing good old fashioned patient care, and having the funding to employ the staff to be able to do it!!
November 16, 2015 at 2:48 pm
We never asked for this in the first place, CQC was forced upon us and whilst I agree with your comments I can’t help thinking we need a two pronged assault. The people to get involved are the patients. The government seems to hold their view in higher regard than ours. I will certainly be addressing this with my PPG in the hope they will also take up the fight.
November 16, 2015 at 2:54 pm
Where do we sign?
We received a good report, but the experience was terrible:
The clinician arrived late
Interruptions to clinics
A report that took 6 months to be written due to CQC sickness…
How do I get a refund on the fees paid please???!! What a joke.
November 16, 2015 at 2:55 pm
Ill sign I am new to the NHS but this is stupid, there is no money in the NHS for for patient care as it used to be and now they want us to pay more. Taking the money what we use for patient care. The NHS baffles me but I am learning fast.
November 16, 2015 at 3:11 pm
Grrrrrr – enough said.
November 16, 2015 at 4:21 pm
….I’m right next to you Nicola….where do I sign?
I’m lost to determine what question the CQC is trying to answer. Is primary care a risk to patients? If it is, what is the evidence? If there is evidence what are the risks and where do they lie? OK once we know this we need to agree a systematic approach to routenely, robustly and consistently support these areas in a positive way.
What we have is the worst of all world with an adversarial approach with dubious intentions based on nothing that has been articulated.
If I were a manager at CQC I’d say if funding is being cut then we need to cut our cloth accordingly. We need to get smarter and more focussed in what we do rather than taking £millions out of primary care looking for something, we don’t know what, and it may not even be there! We should be supporting the weaker areas of Primary Care and not treating it all the same….because it isn’t!
John
November 17, 2015 at 9:14 pm
Hi Nic
You betcha!
J
November 18, 2015 at 9:34 am
100% behind you
November 18, 2015 at 12:28 pm
Agree, but you are peeing into the wind. The GPC is in the government’s pocket, and individual GPs or practices will NEVER stand together and take action. GPs will always run away rather than stand and fight – they retire, or resign and locum, or emigrate etc.
November 19, 2015 at 8:37 am
Obviously a bad day at the office then Harry, glad that we can count on your support
November 19, 2015 at 8:44 am
Well David, you find me one, just one practice that will refuse to pay CQC fees, never mind get the majority or all practices to refuse to pay. GPs will not fight: they resign, retire, emigrate.
November 19, 2015 at 8:55 am
Hey Harry lighten up, its not about what we end up doing or not doing. Its about having a voice, and speaking out about what is wrong here not what GP’s decide to do as an end result. GPs train to have empathy not a confrontation attitude. To most GP’s confrontation is an alien concept to most PMs it is a familiar concept that we tend to handle with as much confidence as a GP deals with a consultation.