The chief inspector of general practice has revealed the Care Quality Commission has already initiated the close of a number of poor practices.

Speaking at yesterday’s NHS Alliance conference, Steve Field also admitted the first thousand practice inspections were “slightly flawed” due to a lack of GPs participating in the visits.

Professor Field said there was “unacceptable variation” among practices, adding: “We have had our heads in the sand and not done anything about. This is professional failure.”

He said: “We won’t tolerate poor practice. We’ve already initiated the closure of a number of practices.”

While he said the CQC was “going to be very tough” he denied inspections were punitive. “We are just going to set standards and inspect the standards,” he said.

Professor Field said inspection “won’t do anything on its own” and had “to trigger more transparent culture”.

He said he was more concerned with a shortage of nurses than the size of the GP workforce, pointing to some inspected practices which had no nurses. “The nurse situation is appalling,” he said. “We’re not training the right nurses at the right time.” He claimed “the model with community nurses and practice nurses being completely separate has never worked.”

Professor Field revealed the CQC board last week approved the criteria that will be used to determine each practice’s rating. It will be shared in a publication published in the second week of December.

The CQC will also produce a report on its first 1,000 practice visits. Professor Field said it was “slightly flawed because there aren’t GPs on all those visits.” He added: “We’ve learnt a big lesson and we will change.”

From April 2014, he said every inspection will include a GP, GP registrar, “hopefully a nurse or practice manager”, a trained inspector and a patient “trained to make judgements”.  

Earlier in the conference, health secretary Jeremy Hunt highlighted the importance of Professor Field’s role.

“Steve giving us an independent view of how good the quality of care is actually going to be more important than [Sir] Mike Richards’ role as chief inspector of hospitals,” Mr Hunt said.

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