Letters Care Quality Commission

A defence of CQC, from an affected practice

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h285 (Published 20 January 2015) Cite this as: BMJ 2015;350:h285
  1. Hendrik J Beerstecher, general practitioner principal1
  1. 1Canterbury Road Surgery, Sittingbourne ME10 4JA, UK
  1. hendrick.beerstecher{at}nhs.net

My practice is marked down by the Care Quality Commission (CQC) on the percentage quinolone to non-quinolone antibiotics prescribed, even though we prescribe fewer quinolones than surrounding practices that are marked as “OK.” This is because we prescribe even fewer non-quinolones than surrounding practices, which results in a higher numerator:denominator ratio.

As McCartney indicates, another problem in the choice of CQC indicators is that of the small disease registers, which invalidates results at practice level.1 For example, if a practice has four patients with a condition and the target is 80%, the effective target for this small practice is 100% (3/4 is only 75% and 4/4 is 100%).

However, it is laudable that the commission published its tool so that it can be improved, rather than using it surreptitiously. There will always be teething problems, because of the law of unintended consequences.

Only in hindsight can the tool be evaluated—whether it really identifies poorly performing practices—but the commission has to start somewhere.


Cite this as: BMJ 2015;350:h285


  • Competing interests: None declared.


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