A commissioning group has challenged Care Quality Commission ratings after a quarter of its GP practices were listed as requiring improvement or inadequate.
The regulator has stuck by the accuracy of its ratings, however. East Leicestershire and Rutland CCG raised “apparent discrepancies” with NHS England and the CQC after discovering the number of practices in the bottom two ratings was higher than comparator CCGs.
Recent analysis of CQC inspection ratings for GP practices by HSJ revealed 3.6 per cent of the 28 practices in the East Leicestershire and Rutland footprint were inadequate, 21.4 per cent required improvement and 75 per cent were good.
East Leicestershire and Rutland CCG had 25 per cent of its practices rated either requiring improvement or inadequate compared to 14.3 per cent of West Leicestershire CCG’s 28 practices and 9.1 per cent of Leicester City CCG’s 44 practices.
Now, after a peer review of the inspection reports, the CQC told HSJ the ratings for the East Leicestershire and Rutland practices would remain unchanged.
Janet Williamson, the CQC’s deputy chief inspector of primary medical services, said: “When we looked over the reports, we found that the ratings rightly reflected the breaches or compliance with regulation that had been observed and made clear in the reports.
“These were also subject to factual accuracy review from the practices themselves before being published.”
East Leicestershire and Rutland CCG carried out an internal review in November comparing practices’ performance in key areas against including CQC compliance, GP survey outcomes and NHS England indicators.
It said its practices were “broadly in line” with the performance of other local CCGs and raised concerns with NHS England over the conflict with the CQC ratings.
In a report to the primary care commissioning committee last week, GP locality lead Nick Glover said NHS England undertook a separate review which “supported the apparent discrepancies” found by the CCG.
The report stated: ”This did not correlate with detailed data we hold which tells us that General Practice in ELR CCG provides good quality clinical care.”
HSJ understands the discrepancies arose because the CCG considered quality from the contracting point of view while the CQC rates practices on how they meet regulations.
Although the CCG said the peer review had found “some variations in approach by lead inspectors”, Dr Williamson said inspections by the CQC followed “a consistent approach and clear methodology”.
She said: “What should be celebrated are those practices that have responded to their reports and taken action to improve the standard of care they are providing to patients, and subsequently their rating.”
Dr Williamson said the CQC had now completed its current programme of inspection and was consulting ahead of the next phase.
Statement from CQC and CCG board papers