Tomorrow, Saturday 30 January 2016, over 300 GP representatives from across the UK will congregate at the Mermaid Conference Centre in London to attend the special LMC conference High on the agenda is the damaging effect of over-regulation of the profession with more motions objecting to the Care Quality Commission (CQC) inspection regime than in any other section of the agenda.
This reflects the findings of GPC’s CQC survey published today, to which over 1900 practices responded in less than two weeks, indicating the strength of feeling on this issue. I thank all of you who provided vitally important feedback on your experience and the impact of preparing for and enduring an inspection.
The results make for damning reading with only one in ten practices feeling that their CQC rating was a fair assessment of the quality of care they provide. The survey further lays bare the scale of time spent, the huge expense and bureaucracy of preparing for and undergoing an inspection, and how this is taking GPs and nurses away from caring for patients. The inspection process has further inflicted significant stress on practices already at rock bottom morale. One in four practices are less likely to raise concerns about practice pressures due to fears of CQC reprisals, which must be an indictment of a regime designed to assure safety.
Key findings from the survey include:
− eight out of 10 GP practices (80%) reported that preparing for a CQC inspection resulted in a reduction in time available to care for patients
− seven out of 10 (70%) had to spend funding on staff overtime while preparing for the inspections, while three out of 10 (30%) had to employ locums
− almost nine out of 10 GP practices (87%) said that on the day of the CQC inspection staff had to reduce GP services available for patients, with almost seven out of 10 (67%) reporting a loss of nursing time
− three-quarters of GP practices (75%) reported that staff suffered from significantly increased stress in preparing for and undergoing inspections – less than 2% reported no impact on stress levels or a decrease
− three-quarters of GPs (74%) felt the inspection regime has made them more likely to leave general practice
− only one in 10 (11%) regarded their final CQC rating as a fair assessment
− one in four practices are less likely to raise concerns about practice pressures due to fear of CQC reprisal.
These findings vindicate GPC’s total rejection of CQC’s proposed seven-fold hike in fees, since the current system appears not to be fit for purpose, is negatively impacting on patient care, and considerably adding to practice staffing costs. The current CQC inspection regime needs wholesale reform that results in an effective, slimmed down process providing targeted support to assure safety, while allowing practices time to focus on treating patients.
Solutions-focused debate at special conference
The special conference will also debate a range of other issues to define possible solutions to the current crisis in general practice. There are motions on defining safe workload limits, increasing consultation times with patients, and looking at the feasibility of removing certain roles from the core GP contract. The workforce section will consider developing the option of a salaried GP service, as well as using physician associates to support GP pressures. Ways of improving recruitment, and retaining experienced GPs will be discussed. The conference will deliberate on how general practice could operate in the future, including within new models of care.
In the run up to the conference, the BMA’s media team has been working to draw out some of the key themes facing tomorrow’s gathering. Kailash Chand writes in the Guardian today on the need to take urgent action to resolve the problems facing our profession, while GPC colleagues, Richard Vautrey, Brian Balmer and Krishna Kasaraneni and others, have talked about possible solutions, the plight of younger GPs, the challenges to the independent contractor status and the overall mood within the profession
The conference will conclude on discussing next steps, and the need for a clear ‘rescue package’ for general practice.
Health Secretary Jeremy Hunt recently stated that he will work with the BMA GPs committee and the Royal College of GPs to announce a package of investment and development for general practice in February. It is vital that he heeds and acts on the messages from this special conference to ensure that 2016 becomes the year of recovery for UK general practice.
For the latest news, visit bma.org.uk/gpc
With best wishes, Chaand Nagpaul
BMA GP committee chair
Urgent prescription for general practice
You may be aware from recent media coverage that the BMA will be launching a campaign, ‘Urgent prescription for general practice’, to highlight the pressures on general practice, drawing on local examples of vulnerable practices and those under imminent threat of closure, and the damaging impact on patient care.
This will kick off with a resource pack, to be sent out to practices shortly, which will include guidance on managing inappropriate workload demands, setting up GP networks to create resilience, and how to highlight local pressures with their local MP, the media and the public. This will be accompanied by publication of the first phase of analysis of your many responses (over 3200), to the December GPC survey on workload pressures to help identify the hotspots, to be followed by a rolling programme to lobby for change.
This campaign will have both a local and national focus to press for urgent government action to stabilise practices who find themselves vulnerable to any or all of the range of destabilising factors currently threatening the profession, including shrinking financial resources, rising workload, recruitment problems and understaffing, as well as providing the support and funding needed for a sustainable general practice of the future. You can read more about the campaign, in Beth McCarron’s article in GP. Beth is the GPC executive lead for the campaign.