Maggots, unregulated fridge temperatures and out of date emergency medicine were just some of the problems found in GP practices by healthcare regulator the Care Quality Commission (CQC).
Since April 2013, when practices had to register with CQC, 1,000 inspections have been carried out focusing on practices where concerns had been raised.
At least 34% of the practices were failing one of the required standards and at 10 practices there were very serious failings.
Chief inspector of primary care Professor Steve Field said there must be zero tolerance on unsafe care.
“I went to one practice where the adrenalin injection was out of date. Now if someone had come in needing that for an anaphylactic shock, they’d be dead.
“I have zero tolerance for this kind of thing, I would wait there until [someone from the practice] gone and bought an injection from the pharmacy,” he said.
The CQC has officially announced its plans for a new inspection regime, revealed exclusively in The Commissioning Review, which will come into effect from April 2014 following consultation.
Inspection teams will be led by a trained inspector and involve a team of about five including a GP, a practice manager or nurse, an expert patient and a GP registrar.
From next April practices will have to answer five key questions: are they safe, effective, caring, responsive to people’s needs and well led.
They will be rated as outstanding, good, needs improvement or inadequate. The new GP contract requires that practices display this rating prominently in the waiting room and on the website.
“There is also some discussion around whether I write to all the patients at a poorly performing practices to let them know and we are looking at the practicalities around that,” said Prof Field.
The CQC will visit each clinical commissioning group once every six months and inspect about a quarter of practices to allow every practice, including those already seen in the first 1,000, to be visited once by 2016.
From January, while the inspection consultation takes place, the CQC will focus on the 46 out of hour providers in England, as it is a high-risk area for poor care.