Chief inspector of general practice Steve Field has said he is happy for struggling GP practices to be taken over by larger providers and NHS trusts if it results in better leadership.

  • Steve Field: “If practice leadership is going to be provided by another trust then I have nothing to say against it”
  • First GP practice leaves special measures regime
  • CQC hires 20 more general practice inspectors in London

Professor Field’s comments came as a Berkshire GP practice became the first to be taken out of the Care Quality Commission’s special measures regime, which was introduced last October.

The Priory Avenue Surgery in Reading was found to be inadequate following an inspection in November and put in special measures in January. It has been re-rated “requires improvement” after being taken over by Berkshire Healthcare Foundation Trust.

Steve Field

All practices placed into special measures have very poor leadership, Steve Field said

Speaking exclusively to HSJ, Professor Field said: “This is a great day for the people of that part of Reading – that practice has improved significantly with support.

“When we went to this practice in November there had been quite a decline in the quality of care in that practice for many months.

“The leadership was very poor, which is what we find in all practices placed into special measures.”

At the time of the original inspection the practice was run by Bracknell based company Specialist Health Services.

Professor Field said: “Following [our initial report] the local CCGs put in a very robust action plan and the Royal College of GPs went in to support the doctors that were employed in the practice.

“In June, Berkshire Healthcare FT took over the contract. That’s quite interesting because it’s the only time a trust has intervened in that way in a failing practice. That probably was the thing that made the most significant difference.”

He added: “We’ve been inspecting practices around the country that are part of bigger federations and groups.

“What we would say is that it’s the leadership [that matters] and if that leadership is going to be provided by another trust then I have nothing to say against it at all.

“It might be that that leadership is provided as effectively by merging with an adjacent practice or by joining a larger group like [multispecialty community provider vanguard] Lakeside Healthcare. It’s the quality of the leadership that’s important on this.”

Professor Field also said the CQC has hired 20 more inspectors to cover London practices. He added that it is in the capital the regulator is “behind on number of inspections at the moment”.

Earlier this week the CQC pushed back its inspection deadlines, including moving the deadline for inspecting all GP practices from April 2016 to September 2016. Sluggish recruitment of inspectors has been one of the causes of the delays.

Professor Field said: “At the moment we have a plan in place to meet the target of [inspecting every practice] by the end of September next year.

“However, part of that depends on the number of enforcement actions we take against practices, and they take time.”

The CQC has yet to publish re-inspection reports on two practices placed into special measures at the same time as Priory Avenue. These are:

  • Dharmana’s Family and General Practice in Liverpool; and
  • Norris Road Surgery in Greater Manchester.

Under the regulator’s rules, if a GP practice is still found to be providing inadequate care after six months, it will have its CQC registration cancelled and face having their contract terminated by NHS England.