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Will the CQC's new regime penalise small practices?

Which (of two evils) is preferable: an under-doctored practice that, on a few critical occasions, when it simply does not have the resources to cope, refers patients to the local walk-in centre for care; or one that goes ahead and remains open, using burned-out, exhausted (and potentially unsafe) GPs to care for patients?

I suspect most GPs and fellow health professionals would suggest the former, but when this scenario did occur for a respected GP practice with a strong reputation, in a deprived urban location, NHS England served them with a notice that they were in breach of their terms of service. The practice is currently working through the consequeneces of this.

Would the CQC recommend placing this practice in special measures, or compliment them on their responsible judgement? Would patients be understanding?

The way in which the DH has undervalued general practice and the media has encouraged the public to do the same, has led to a critical point in GP recruitment. The practice highlighted above was unable to recruit the additional staff it needed. It wasn’t the fault of the practice, what could they have done?

Will the CQC deal equitably with a practice that has 30,000 patients and a practice that has 2,000 patients? Will it attempt to disperse 30,000 patients if the practice fails to improve? Of course not.

Undoubtedly, there are some under-performing GPs (there are also, shocking though it is to say, some under-performing accountants!) but the reasons behind their failures have to be understood. Few people set out to do their jobs poorly. My prediction is that the new CQC inspection regime will end up being used as a stick with which to beat smaller practice. No wonder there are so many practice mergers taking place: there is some safety in numbers.

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