Almost every surgery in the UK is now ranked according to CQC criteria on quality of care, with the majority of practices falling into a ‘low concern’ category. The ratings system has been put in place to empower patients to make choices about their care provider and to increase a sense of shared accountability in the health service, though figures within the NHS fear that the inspection and data results could mislead.
Patients will be able to look up their own practice and see how it scored – and see details on any areas of potential underperformance – by entering their postcode into an online tool on the Care Quality Commission’s website.
11% of inspected practices are currently considered to be in the highest risk group – with patients often subjected to ‘chaotic and potentially unsafe’ care – and one in six providing care that could be deemed below par. Issues with booking appointments, cervical cancer screening and mental health plans came up frequently as flashpoints with failing practices, though the watchdog does claim that the register data cannot and does not necessarily indicate poor performance, but this initial data is a further tool to help the CQC decide which practices to inspect first, and which areas certain practices might need more targeted inspection.
The CQC ranked practices using 38 indicators pertaining to levels of patient risk. Practices were then graded in six bands, with Band One presenting the biggest concern. Risk indicators included issues such as:
• Unnecessary A&E admissions
• High prescription rate for antibiotics
• Incidence of coronary heart disease
• Emergency cancer admissions
• Failure to meet flu vaccination targets
• Diagnosis rates for dementia
• Cervical screening test numbers
• Diabetes care
• Ability to book an appointment
Regional variation is clear to see in this data, with a quarter of London practices being ranked Band One or Band Two – the riskiest categories. The North East ended up with the best turnout for safe, low risk practices.
The CQC inspected 336 GP surgeries this year, and all surgeries should be inspected by March 2016 under a new inspection regime.
Further analysis shows that small practices are at greater risk of giving substandard care because GPs are more isolated and not always reflecting on mistakes. Though Dr Richard Vautrey from the BMA’s GP committee was keen to warn that, “publishing data with no context about a GP practice before inspectors have even arrived will at best confuse patients and at worst mislead them… The information does not take into account the differing circumstances GP practices operate in, including levels of deprivation in the community they deliver care to.”
CQC chief inspector Steve Field’s message is that, “it is only when we inspect [that] we can determine if a practice provides safe, high-quality and compassionate care.” What do you think?