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‘Special measures’ system could lead to practice closures

15 August 2014

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From October practices providing inadequate care will face closure under a system of “special measures” proposed by the Care Quality Commission (CQC). 

Practices under special measures will be set clear expectations for improvement, including a timescale, by the CQC and NHS England. 

If, after a year the surgery has failed to improve, they will have their registration with CQC cancelled and could have their contract terminated by NHS England. 

Patients registered at the practice would continue to receive GP services through CQC and NHS England “joint planning”. 

In some cases, a GP practice will have such significant problems that patients are at risk, or there will be sufficiently little confidence in the practice’s capacity to improve on its own, that the practice will be placed straight into special measures.

However, Royal College of General Practitioner (RCGP) chair Dr Maureen Baker said that labelling failing practices is not the solution. 

She said: “Patients should expect high quality and consistent care from every GP practice and the vast majority of practices do an excellent job of delivering care to the highest possible quality standards. 

“There are also a small number of practices who are struggling to meet quality standards, often due to factors beyond their control, such as lack of funding, significant increases in patient consultations and difficulties in trying to recruit sufficient GPs to meet patients’ needs.” 

Dr Baker said the RCGP will ensure that special measures do not become “another stick with which to beat hardworking GPs”. 

CQC chief inspector of primary care, Professor Steve Field (pictured) said: “Special measures will firstly promote improvement, but where practices do not improve, working with NHS England will call time on poor care. Special measures will be viewed as the final chance for a practice to improve. 

“When health and care organisations fail the people to whom they provide care, it’s important that failure is identified quickly and the action is to ensure services for people improve.” 

Mike Bewick, deputy medical director for NHS England, said: “NHS England’s vision is to see general practice play an even stronger role in the heart of local communities, offering more joined up, high quality services. As part of this, we want to help GPs to provide ever higher standards of care to patients.”

Niall Dickson, chief executive of the General Medical Council, said: “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. Family doctors are now subject to regular checks, but the inspections in England are bound to expose areas of weakness as well as good practice. We will work closely with CQC and local Responsible Officers to help drive up standards.”