Perspectives on UK Care Quality Commission’s Inspections of Primary Care Practices

Abstract

Background In the middle of a pandemic, when the health and social care services were experiencing their worst challenges and staff were facing burnout, the feedback from primary care professionals raised concerns on the UK Care Quality Commission’s inspection regime and specially on its effectiveness, impact on services and particularly relating to its equality, diversity and inclusion aspects.  Methods An online anonymised survey was carried out in July 2021 and received 130 responses, the majority from the GP partners but also locum and sessional colleagues as well as other members of the general practice team. Results About 80% of respondents reported having a good rating or an outstanding rating. But fewer than 20% of the participants felt that their experience of the CQC inspections was positive. More than 85% of respondents feel that the inspections did not add value to the clinical care or prevent harm. 80% felt that the inspections were not fair, transparent, objective, or replicable and found these to be traumatic rather than being a positive or constructive experience. More than 50% felt that Practices led by Black and AsianGPs small practices and those inner city, and rural practices in areas of deprivation receive disproportionately poorer outcomes. Three in four respondents felt that the inspections were intense and took staff away from direct clinical care. Almost 86% of respondents felt that the inspectors demonstrated insights into the systemic challenges faced by primary care. About half of the respondents did not feel supported by the LMCs and/or their CCG.  Discussion & Conclusion The findings demonstrated that the inspections were not considered to be effective or constructive and took the general practice team away from patient care. Of particular concern was that perception that the system was unfair and discriminatory for Black and Asian GPs small practices and those in inner city or rural locations with multiple deprivation. The authors urge the CQC to ensure that the profession is supported and that any inspection process is fair, non-discriminatory and improves patient care.