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CQC to pause use of QOF data to monitor GP practice safety

by Caitlin Tilley
4 October 2021

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The CQC has stopped using QOF data to assess practices for ‘at least’ 12 months, because it is ‘not reliable’ and ‘many months out of date’.

Instead, it will monitor practices through ‘additional searches’ carried out by doctors on practice clinical systems ‘from a distance’ and ‘with their permission’.

QOF data has been ‘skewed’ by the pandemic and is often ‘many months out of date’, CQC head of inspection for primary medical services Andy Brand said in a webinar last week.

The regulator will stop using QOF data for ‘at least’ a year, and then review if and how it uses it after that.

Dr Rosie Benneyworth, chief inspector of primary medical services and integrated care at CQC said: ‘QOF requirements were modified by NHS England and Improvement (NSHEI) for 2020/21 to recognise the need to reprioritise aspects of care which were not directly related to Covid-19. 

‘NHSEI have issued guidance in relation to the General Medical Services (GMS) contract, stating that, due to the Covid-19 pandemic, the majority of indicators in the 2020/21 QOF data collection have been placed into income protection.

‘CQC have decided that currently the data on the Calculating Quality Reporting Service (CQRS) for QOF 2020/21 offers limited value to CQC in terms of inspection and monitoring purposes.’

The extra searches used instead will include patients with diabetic retinopathy with their most recent HbA1c>74, and patients with stage 4 or 5 chronic kidney disease who have not had a blood pressure reading or urea and electrolytes test in the last 18 months.

The CQC will continue to rate practice performance based on key questions rather than in terms of population groups, but it will combine the questions ‘Are care services effective?’ and ‘Are they responsive to people’s needs?’ into one.

The regulator will also use more video calls for interviewing staff in inspections and make reduced checks on surgeries rated ‘good’. 

Earlier this month, CQC chief inspector for primary care said on-site CQC inspections for outstanding practices will not return for the ‘foreseeable future’.

As part of CQC’s new approach to monitoring primary care services, it has been making monthly virtual checks on ‘all data and information’ it holds about practices since July.

This data includes current CQC ratings, breaches, safeguarding concerns and patients’ experiences. 

If that is satisfactory, the practice will receive a CQC review and short statement. If it is not, there may be a phone call with the provider.

In June, NHS England said it has ‘no plans’ to suspend QOF or income-protect it for GP practices this year.

It comes as the BMA said it is ‘seriously concerned’ about CQC’s remote monthly GP practice safety reviews that launched in July.

In June, a draft document revealed that the regulator planned to start carrying out remote checks on each GP practice every month to assess its risk to patients in July.

Meanwhile, the CQC has recently faced criticism from some GPs who perceived inspectors’ behaviour as inappropriate.

Last month, a small survey found that more than 70% of GPs from minority ethnic backgrounds described ‘CQC inspections and the behaviour of the CQC inspection team has been a traumatic experience, rather than a positive and constructive experience’.

This story first appeared in our sister title, Pulse.