Poor GP services may close say health regulators

Poorly performing practices will be put into a new failure regime and those that don’t improve will face closure, the Care Quality Commission (CQC) said.

GP surgeries will receive Ofsted-style ratings – where they are deemed to be outstanding, good, requires improvement or inadequate – and those that are given the lowest rating face being put into special measures. If they fail to make improvements following this they could be shut down.

Inspectors will assess whether England’s 8,300 GP practices are safe, effective, caring, responsive to people’s needs and whether or not they are well led.

The quality commission’s chief inspector of general practice Professor Steve Field said that from October this year failing practices will face being put special measures .

He said he wanted to “call time on poor care”.

When parts of a GP practice’s service are deemed to be inadequate they will have six months to improve their services and if after this deadline they have failed to get better they will be put into special measures.

If after another six months the practice has shown no signs of improvement, they could have their registration with the health regulator cancelled or their contract terminated by NHS England – meaning that they would be forced to close.

Those that are performing exceptionally badly will be immediately put into the failure regime, the commission said.

Pilots of the inspection regime, which see a specialist GP advisor join the team scrutinising GP surgeries, found that most practices are providing high quality care – but that a small number are “very poor”, CQC said.

“Most GP practices provide good care,” said Prof Field.

“We have confirmed this in our pilot inspections so far. But we can’t allow those that provide poor care to continue to let their patients have an inadequate service. I want to do all I can to drive up standards in those that are not providing the services people deserve.

“We need to have a clear framework and a process to respond to those GP practices that are providing inadequate care to ensure that they can’t continue to provide inadequate care indefinitely.

“Special measures will firstly promote improvement, but where practices do not improve, working with NHS England we will call time on poor care.”

The regime could also see more doctors referred to the doctors’ regulator, the General Medical Council (GMC).

Niall Dickson, chief executive of the GMC, added: “Whenever CQC’s new inspection system raises concerns about the competency of individual GPs, the matter will be referred to the GP’s local responsible officer and if necessary to the GMC.”

However, Dr Chaand Nagpaul, chairman of the British Medical Association’s GP committee warned: “It is important not to create a counter-productive blame culture based on isolated examples.”