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GP inspections: are sanctions holding back improvement in poor areas?

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k682 (Published 14 February 2018) Cite this as: BMJ 2018;360:k682
  1. Gareth Iacobucci
  1. The BMJ

The BMJ has found a relation between levels of deprivation and the likelihood of CQC sanctions. Gareth Iacobucci considers the consequences

GP partners working in England’s deprived areas who have had negative feedback after inspections by the health and social services regulator have told The BMJ how they were left feeling demoralised, unsupported, and on the brink of giving up.

One GP said he thought that the Care Quality Commission failed to take account of the challenges his practice faced, another that being put under special measures made hiring staff even more difficult and improvements near impossible to achieve (box 1).

Box 1

GPs’ responses: CQC criticism was like “a kick in the teeth”

The BMJ spoke to a partner at one practice that the CQC placed under “special measures” and that remains under scrutiny. The GP, who wished to remain anonymous, said the inspection that led to the action had been “particularly unsupportive.” The sanction felt like “a kick in the teeth,” the partner said, and made it hard to hire new staff.

“We were being inspected for a second time, and all the staff thought we were in a much better place than we had been on the previous inspection. But then we got absolutely hammered. Speaking to other people, we found that the reasons we were put into special measures were not consistent compared with other practices.

“Being rated in special measures was almost what tipped us over the edge, because it suddenly meant that recruitment was incredibly difficult. I seriously considered handing back the contract at that point. Having worked incredibly hard to try to turn round the practice and worked all the hours that God sent, to then be told that you’re the worst of the worst was pretty demoralising.”

Another GP …

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