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NOV 21/2014

Special measures for GP surgeries: A step forward for the sector?

The Care Quality Commission (CQC), England’s healthcare sector regulator, has recently announced it plans to introduce special measures for NHS GPs, due to overwhelming success the model has achieved in other sectors.

Special measures were originally introduced to help 11 trusts, including the Mid-Staffordshire NHS Foundation Trust, make improvements in several areas. After a year, significant positive developments were seen in ten of the trusts, as staff had worked together to identify the problems and provide effective solutions.

From October, the system will be rolled out to GP practices, meaning those found to be providing inadequate care will be given deadlines for improvement. The introduction of the process coincides will the launch of the CQC’s rating system, which will see organisations being classed as either outstanding, good, requires improvement or inadequate. 

Clear expectations
In order to perform well or improve, GP practices need to know what is required of them, which is why the CQC will be setting out clear expectations for the outset. The regulator will work closely with NHS England to ensure these are rolled out properly and to make sure all practices are aware of the timescales allowed to make any necessary changes.

If any a practice is deemed to be providing an inadequate service they will be given six months to turn things around. After that time has elapsed, if improvements haven’t been achieved then it will be placed in special measures. The practice will be given a further six months to make the necessary changes.

Commenting on the new system, Professor Steve Field, chief inspector of general practice at the CQC, said: "Most GP practices provide good care. We have confirmed this in our pilot inspections so far. Special measures will firstly promote improvement, but where practices do not improve, working with NHS England we will call time on poor care. Special measures will be viewed as the final chance for a practice to improve.”

Mike Bewick, deputy medical director for NHS England, added that he wants to see GP practices play a stronger role in local communities, which can be achieved by offering more joined up and quality services.

He continued: “As part of this, we want to help GPs to provide ever higher standards of care to patients."

Reaction from the industry
Dr Maureen Baker, chair of the Royal College of General Practitioners (RCGP) believes that while most GP practices do an excellent job of delivering high standards of care, a small minority struggle to meet quality requirements often due to factors that are beyond their control.  

She said the RCGP “welcomes the opportunity” to play a large role in supporting GP practices so they are able to provide the best possible care to their patients, adding: “As the UK’s largest medical royal college representing nearly 50,000 family doctors, our role will be to assist practices to compile and implement plans to improve the service for patients.”

The British Medical Association (BMA) echoed the RCGP’s sentiments, adding that patients should receive the best standards of care regardless of the GP practice they are registered with.

Dr Chaand Nagpaul, chair of the BMA’s GP committee, said the majority of England’s 8,000 GP practices provide excellent service, with patient care and safety being doctors’ number one concern.

He added that it is important the issues behind the failings are understood so they can properly be addressed. Dr Nagpaul continued: “We need to focus on providing support and enabling improvement in those GP practices that need help.”

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