05.12.14
CQC backtrack on GP risk rating system shows it is “not fit for purpose” – BMA
The admission by the Care Quality Commission (CQC) that it is having to re-calculate all of its pre-inspection data for GP practices highlights that the “risk rating system” is “not fit for purpose”, according to the British Medical Association (BMA).
Problems with calculations in the GP Intelligent Monitoring (IM) system, which was only introduced last month, has led the regulator to apologise to some practices that had been placed in higher priority bands.
In fact, about 60 practices have been taken out of the high-risk categories (Band 1 and 2), but seven practices will move into a higher priority band as a result of changes made to the system.
When using the GP IM system practices were judged on 38 performance indicators, and graded in six bands, with Band 1 being the highest concern, and Band 6 the least risky. The majority were of low concern, but 11% were rated in the highest risk band.
In a letter sent to stakeholders, Professor Nigel Sparrow, senior national GP advisor and responsible officer at CQC, wrote: “We will contact each of those practices to apologise for any concern this may have caused GPs, their staff and their patients.
“I would like to take this opportunity to reinforce the message that the banding is not a judgement. Intelligent monitoring helps us to prioritise our inspection programme as well as informing the questions we will ask during the inspection. Intelligent monitoring will never be used in isolation to make a final judgement or produce a rating of a GP practice.”
Within the IM update, the CQC has, however, removed the patient survey indicator GPPS005, which looked at the proportion of respondents to the GP patient survey who stated whether they were able to get an appointment the last time they wanted to see or speak to a GP or nurse from their surgery.
A further four indicators had to be refined based on revisions to data provided to the CQC by NHS England.
Dr Chaand Nagpaul, BMA GP committee chair, said: “We now know that due to errors in the CQC’s methodology 60 practices have been unfairly branded as being at risk, potentially doing serious harm to their reputation.
“The chopping and changing of target indicators which has resulted in a different risk banding being allocated to GP practices demonstrates the problems of using limited skewed data, rather than adopting a transparent approach.
“We warned at the time that simplistic targets would fail to take into account the enormous pressures GP practices are facing, and that skewed and limited information does not tell us about the quality of care.”
The CQC added that updated IM reports and more information will be available on its website from Monday.
UPDATE:
Dr Maureen Baker, chair of the Royal College of General Practitioners, said: “This is shocking news especially for the GP surgeries who have been wrongly labelled and for the patients whose trust in their family doctors has been cruelly shaken.
“It is ironic that a system that was introduced supposedly to support patients has left them confused and let down. The damage caused by this episode will not easily be undone.
“The publication of these over-simplistic bandings has stigmatised hard-working, family doctors, who are trying their hardest in very difficult circumstances to provide the very best care for their patients.
“To discover that the data on which these banding decisions were based is severely flawed will further demoralise our hard-pressed GPs and destroy any semblance of confidence that they had in the inspection system.
“We absolutely recognise and support the need to provide transparent, meaningful information to the public about the care provided by their GP practice.”
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