Practice managers are urging the Government to abolish the ‘unfair’ one-word ratings given to surgeries after a CQC inspection, amid a similar move being made for schools.
The Institute of General Practice Management (IGPM) has written to the Department of Health and Social Care (DHSC) requesting the change be made immediately, following last week’s announcement that single word grades given to schools by the inspectorate Ofsted have been scrapped.
Practices are given four headline ratings of outstanding, good, requires improvement and inadequate – the same that were used for schools.
However, the Department for Education (DfE) said it is moving away from that system since ‘reductive single headline grades fail to provide a fair and accurate assessment of overall school performance across a range of areas.’
Now the IGPM has said these concerns apply just as much as to general practice as the education sector and is asking the DHSC to follow suit.
In a letter to health secretary Wes Streeting, signed by IGPM directors and written by its regional representative, Adrian Down, members said the concerns raised by the DfE ‘resonate deeply with our own concerns regarding the application of similar ratings to GP practices’.
The organisation said the single rating approach fails to take into account the ‘individualised nature of healthcare delivery in general practice’ and that the system is not only unfair but also undermines trust between patients and practices, and can demoralise staff, with practice managers’ wellbeing at particular risk.
The letter said: ‘The delivery of healthcare, like education, is a complex and multifaceted endeavour. GP practices are assessed across a wide range of criteria, from patient care and safety to the effectiveness of services and the quality of leadership. Reducing such a comprehensive evaluation to a single word fails to capture the nuances of each practice’s performance and can mislead the public, patients, and even the practice themselves.’
It added that since practices have unique patient populations, with varying needs and challenges, ‘the application of a uniform rating system does not fairly or accurately reflect the quality of care provided’.
Not does it provide the public with accurate information they need to make informed decisions about their healthcare providers, it said.
The IGPM levelled criticism at the CQC inspection process too describing it as lacking consistency, with the result that practices may be judged differently ‘on the subjective interpretations and priorities of individual inspectors’, rather than on the quality of care they provide.
Significantly, the letter also raised the issue of the impact of inspections on practice manager and staff wellbeing. It makes reference to the tragic suicide of headteacher Ruth Perry and the fact an inquest ruled that a critical Ofsted report had contributed to her death.
‘The practice managers we represent share similar standing with headteachers, with the same passion for their role and the people in their care,’ IGPM leaders wrote in their letter. ‘We urge you to consider the impact of one-word inspections on the wellbeing of practice managers and the hard-working teams within general practice.’
The institute has asked the Government to explore alternative methods of assessment that would provide ‘a more comprehensive and nuanced reflection of a practice’s performance’. And it has asked to be a part of any review or consultation process on the issue.
A Department of Health and Social spokesperson told Management in Practice that it is not currently considering a change to the single-word ratings system, but added that it is ‘thoroughly reviewing the CQC and as part of that work we have asked the CQC to improve the transparency of their ratings’.
The CQC began the rollout of a new inspection regime last November although the four headline ratings remained unchanged.
Meanwhile, earlier this year, health secretary Wes Streeting said the CQC is ‘not fit for purpose‘ following an independent review.
