• Poor quality GP surgeries scattered across the Midlands and East region, with the worst three performing CCGs in Essex, Nottinghamshire, and Lincolnshire
  • Three neighbouring CCGs in south Essex appear in the 10 CCGs with the highest percentage of inadequate or requires improvement CQC ratings
  • Nottingham West outstrips all other areas for quality performance, with almost half of its surgeries rated outstanding

In-depth analysis of Care Qquality Commissioning ratings of GP surgeries shows pockets of good and bad primary care performance scattered across the England Midlands and East region.

The three worst performing clinical commissioning group areas are located in Essex, Lincolnshire and Nottinghamshire. South Essex particularly has problems.

HSJ reviewed all CQC GP inspection reports published by 1 March 2017, to reveal the number of GP surgeries in each CCG that received a rating of inadequate, requires improvement, good or outstanding.

The findings show that three neighbouring CCGs in south Essex are some of the worst in the country for the number of GP surgeries rated inadequate or requires improvement by the regulator.

Thurrock CCG tops the list with 36 per cent of surgeries receiving either of the bottom two CQC ratings (see table below). Nearby Castle Point, Rayleigh and Rochford CCG has almost 29 per cent of surgeries with these ratings, while Southend has 24 per cent.

Rahul Chaudhauri, head of primary care at Thurrock CCG, said: “In Thurrock we face a unique situation where many of our GPs are working single-handed in premises that are often converted homes, rather than dedicated healthcare buildings. Thurrock is traditionally under-doctored with many nearing retirement. We are working with NHS England, who commission primary care in the area, to restructure and improve primary care facilities in Thurrock [and] we are confident with our plans for updating premises and improving quality, we will see a marked improvement in primary care in Thurrock over the next three to four years.”

Other areas with primary care quality concerns include South Lincolnshire on the east coast, parts of Birmingham and North Staffordshire.

Areas with the most GP surgeries rated outstanding are similarly spread out (see second table). Nottingham West CCG outstrips all other areas for quality performance, with almost half of its surgeries rated outstanding. Rushcliffe is the second best area with 27 per cent of primary care providers receiving the top rating.

HSJ analysed 6,476 GP practice inspections across England out of a total of 7,705 inspected by the CQC, which accounts for 84 per cent of all surgeries. The regulator is still to publish the remainder of its GP inspection reports. It is the first time GP practices across the country have been comprehensively inspected and rated.

Top 10 CCGs in the Midlands and East with the highest percentage of GP surgeries rated requires improvement or inadequate

CCG % of GP surgeries rated inadequate and requires improvement
Thurrock 36.4
Mansfield and Ashfield 31.8
South Lincolnshire 28.6
Castle Point, Rayleigh and Rochford 27.3
West Suffolk 26.3
Sandwell and West Birmingham 26.1
East Leicestershire and Rutland 25.0
Southend 24.1
Walsall 23.4
North Staffordshire 20.0

Top 10 CCGs in the Midlands and East with the highest percentage of GP surgeries rated outstanding

CCG % of GP surgeries rated outstanding
Nottingham West 46.2
Rushcliffe 27.3
North Derbyshire 22.9
South Warwickshire 19.2
Southern Derbyshire 18.5
Solihull 18.2
South Norfolk 18.2
Hardwick 15.4
Norwich 15.0
Mansfield and Ashfield 13.6
Shropshire 13.6