The Care Quality Commission will “campaign” for longer consultations and greater increases in the GP workforce, its professional adviser on primary care has said.
Nigel Sparrow also said the system being developed by the inspectorate would not result in practices receiving a “single” overall rating and would be “upset” if such as system was ever introduced.
Professor Sparrow will work with Steve Field, who became the CQC’s first chief inspector of primary care this month, to develop a new inspection regime and publish quality ratings for all practices.
In a HSJ interview, Professor Sparrow said the CQC would take a “practical and pragmatic approach” to general practice, checking it was responding to patients’ needs. As an example he said many practices did not need to open later in the evening.
“We want patients to have access [and practices should be] responsive to people’s needs. [But] not everybody wants to see their GP in the evening.” He said at his practice in Nottinghamshire, “we asked patients, ‘Do you want us to open later?’ and hardly anyone did”.
His comments follow a call by the prime minister last month for longer practice opening hours.
“The problem with opening longer is you will be spreading the workforce thinner,” said Professor Sparrow, who is also a senior figure in the Royal College of GPs and its lead for revalidation.
He said the government needed to dramatically increase the number of GPs so consultations could be longer.
“We will campaign for that. We can work with stakeholders, work with RCGP,” he said.
“We will highlight these issues… [Health secretary] Jeremy Hunt has said 2,000 GPs [will be trained] – that is nowhere near enough. That is a step in the right direction but we need 10,000.”
Without a bigger workforce, “We can open longer but we won’t increase service”, he said.
The new inspection regime and quality ratings will be consulted on in coming months. Professor Sparrow said it should not result in practices receiving a single quality rating or measure. “I will be desperately upset if we have one rating,” he said.
Practices are more likely to receive five ratings, under each of the CQC’s regulation domains – safety, effectiveness, caring, responsive to people’s needs, and being well led.
“We don’t want to end up with a set of un-useful league tables,” he said. It is likely to take at least two years to inspect and rate all practices, of which there are around 8,000.
Professor Sparrow said the CQC would “highlight areas that aren’t good” and the “trailing edge that drags down the rest of general practice”.
However, he said many problems discovered so far were relatively straightforward, such as “drugs in emergency bags that are out of date” and “vaccine fridges which don’t have a proper temperature lock”.
He said the CQC would also “highlight areas of good practice” and was cautious about its role in reshaping services.
“[The CQC] is there to regulate but it’s also there to drive up standards. [However] we’re not into service redesign,” he said.
“We will not be telling people what to do. We highlight issues but we can’t tell people to redesign their services.”
Professor Field told HSJ earlier this month his work, “isn’t just about looking at the provider, the GP practice or the dentist or out of hours, this is about looking at the system”.
He has also said: “A lot of patients are dissatisfied with current [GP] access and think it’s inadequate.”