Unsafe GP surgeries may be closed after ‘two-strikes’ policy


GP practices which offer unsafe or poor care could be shut down after a new policy of ‘two-strikes-and-you’re-out’ which is set for introduction by the NHS regulator.

This new policy immediately activated claims by practitioners that they may be unfairly blamed for issues that were beyond their control.

This is being viewed as the ultimate sanction which has been included in the Care Quality Commission’s (CQC) plan to include general practice in the ‘special measures’ regime for hospitals which are failing.

As from October, surgeries which are deemed ‘inadequate’ by the CQC will be given a period of six months, but some may only receive a few weeks, to draft and implement a plan for improving their facility. Any of the surgeries which fail to address the relevant concerns quickly enough will be placed into ‘special measures’. This allows the funder of general practice, NHS England, to take control of the implementation of changes as they see fit. This may include extending the surgery hours or hiring additional staff.

If a maximum period of six months has passed and there are still problems in the surgery, the CQC will be able to cancel the registration of the practice, thereby shutting it down.

According to the CQC’s chief inspector of primary care, Professor Steve Field, a surgery could receive an inadequate rating if evidence or an inspection by CQC reveals failures, such as mismanagement of medicines, bad hygiene or not doing staff criminal record checks. Field said that if a practice receives an inadequate rating, it will be the start to force fast improvement.

He added that most surgeries offer high quality care, but there are a few that do not. Problems at a single surgery could affect thousands or tens of thousands of patients, depending on the number of practitioners available.

The chair of the British Medical Association’s (BMA) GP committee, Dr Chaand Nagpaul, said that patients should be offered the best care from their medical practice, and most provide this. However, he has issued a warning that a blame culture due to isolated examples which could result in patients not trusting the wider medical services should be avoided.

He said that a surgery could be experiencing problems due to underfunding, premises in a state of disrepair, or difficulty in staff recruitment. He does not want GP practices to be closed when all that is required is good quality care for patients.

Recent inspections by the CQC have found that most of the problems are experienced by small surgeries where there are one or two doctors.

This crackdown by the CQC will also take into consideration patient complaints and information collected by bodies such as HealthWatch. There are already some practice managers and nurses who have rung the CQC hotline to raise concerns about the surgery they are employed at.

NHS England is ready to make alternate arrangements for patients who may be affected by closures.

Image Credit: Matthew Anderson


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