CQC may not be fit to register GP practices, MPs warn

Authors: Adrian O’Dowd 

Publication date:  31 Mar 2012

MPs have raised fears that the Care Quality Commission (CQC) might be unfit to register the 10 000 general practices in England later this year.

In a review by the House of Commons Committee of Public Accounts of the commission’s operations, MPs heavily criticise the CQC for failing to be an effective regulator and raise serious questions over its governance, leadership, and culture.

“We are far from convinced that the CQC is up to the major challenge of registering and assessing 10 000 GP practices this year,” said Margaret Hodge, Labour MP for Barking and chairwoman of the committee. “Registration will now be decided on the basis of information from GPs themselves, and there is a risk that the CQC will simply become a postbox.”

Its role in ensuring quality standards and deterring poor quality and unsafe care had not been fulfilled effectively, and it had not achieved the right balance between registration and inspection, said MPs.

As the independent regulator of health and adult social care in England, the CQC, which was formed in 2009 from the merger of three previous regulators, currently regulates more than 21 000 care providers against 16 essential standards of quality and safety.

Between September this year and April 2013 the commission will carry out what the MPs’ report describes as a “major challenge” in registering 10 000 general practices, and the committee said that it was unconvinced the regulator was up to the task.

“In the past, the commission’s inspection work has suffered when it has had to register large groups of providers,” says the report. “It shifted its focus to registration and carried out far fewer inspections than planned.”

Learning from these problems, the CQC then changed its processes so that registration of general practices will now be decided primarily on the information provided by the GPs themselves.

Asking general practices to declare themselves whether they are meeting the essential standards does however carry risks, says the report. The commission will therefore have to ensure that the registration process is robust and provides meaningful assurance about the quality of GP surgeries.

A spokesman for the commission responded to the report saying: “We are disappointed that the report does not recognise the significant improvements of recent months.

“The CQC asked the secretary of state for additional time to get GP registration right, and we are on track to deliver this major piece of work successfully by April 2013. GPs will be subject to the same risk based model of compliance monitoring and inspections as the rest of the NHS and social care—and will be expected to meet the same essential standards of quality and safety.”

  • The Care Quality Commission: Regulating the Quality and Safety of Health and Adult Social Care is at [Link] .

Adrian O’Dowd London

Cite this as BMJ Careers ; doi: