More details emerged of how the lead GPs of poorly performing practices have been replaced following Care Quality Commission inspections.

Steve Field, the chief inspector of general practice, told HSJ that in “at least in two practices” the GPs in charge “are no longer running the practice.”

He added: “Care in one is being provided by others. In another, the list is being dispersed [by NHS England to other practices] at the moment.”

The revelation came as CQC today sets out its new inspection process for general practice, which will come into force in April next year.

However, a planned report into the first 1,000 general practice visits has not materialised. Professor Field announced the report would be produced when he spoke at an NHS Alliance conference in November.

Since introducing GP inspections in April 2013, the CQC has carried out 910 initial visits and 90 follow-ups.

Ten practices were found to have major problems.

One of those practices, the Kinghurst Medical Practice in Birmingham has volunteered to deregister and is now being run by a new provider.

Professor Field revealed that in one practice both GPs referred each other to the GMC for incompetence. Both have since left the practice.  

Warning notices have also been issued to the Dr Amira Syed practice in Lancashire and the Long Street Surgery in Wigston, Leicestershire.

A third of all practices had problems with some essential standards. Some practices had been specifically targeted for inspections because they were identified as having problems.

Professor Field said the role of the CQC was to “write factual reports” about what it finds and said it was the responsibility of clinical commissioning groups working with their local NHS England area team and the practice to look at how to address any problems found. However, he said he hoped inspection would “trigger better working relationships” between organisations about improving care.

He added “many of the inspectors have been absolutely fantastic”, but feedback from GPs found they were given too short notice before initial inspections took place, disrupting work with patients. GPs also found the way reports were written made them difficult to understand.

Maureen Baker, chair of the Royal College of GPs, said it was “crucial that any inspection of GP practice should have input from people who have direct experience of frontline general practice”. She added: “We must make sure that GPs, practice nurses and practice managers are not taken away from the day job of providing care to patients as a result of their involvement in inspections.”

In October, the CQC will begin to rate practices across a range of criteria, as well as assigning an overall rating. Practices will be required to publish their ratings on their websites and display them in their waiting rooms.

The CQC intends to inspect and rate every GP practice by April 2016.