Dear Editor,
I am sure that many readers will feel concerned about the quality of general practice having read the recent media coverage.
The reporting demonstrates the limitations of the data published by the Care Quality
Commission.
All practices will be subject to the inspection process that you describe; the CQC aim to inspect all practices by March 2016. The CQC is using a number of different types of evidence to decide how it should prioritise its inspections, such as surveys and patient experience data.
It is important that people understand that this is not designed to be a ranking of quality of the service delivered by practices.
CQC states clearly ‘This isn’t a judgment on GPs. The profiles bring together information that helps us make decisions about inspections.’
Furthermore, the data that has been used to determine whether a practice is high or low priority for an inspection visit is not new information and possibly now out of date.
The inspection visits are a means of helping to determine whether practices are ‘safe, effective, caring, responsive and well led’. The criteria used to assess the prioritisation of inspection visits are not designed to assess a practice against these important aspects.
For example, let’s consider a Practice that makes a lower than predicted number of dementia diagnoses. This is an outcome measure that assesses the number of patients given the label
of dementia against the number of people estimated living with dementia in the population.
Not only is the gold standard by which a practice is judged an estimate, this measure is the number of people whom the Practice have labelled as having dementia and not a marker of the quality of care actually provided to patients who have memory problems.
By any fair and
reasonable measure, this doesn’t mean that the practice is ‘poorly performing’ or ‘putting patients at risk’. I use the dementia diagnosis rates as an example; this is also true of other outcome measures that have been deemed to be ‘risk factors’.
GP Practices are committed to delivering high quality primary care and welcome all
inspections that highlight good practice and support the further development of the service.
Patient satisfaction surveys repeatedly show a very high level of satisfaction with general practice despite GPs being under significant pressure in terms of workload.
In today’s society we are quick to complain and slow to praise. If you are happy with the quality of care you receive from your practice, tell them – it’ll do wonders for the morale of those dedicated to delivering your high quality care. However, if you are not happy with the standard of care you are receiving, please do discuss it with your practice and help us to help
you.
Practices will be delighted to work with you to develop their services.
It has been said ‘Not everything that can be counted counts, and not everything that counts can be counted.’
Never was a truer word spoken about the complex and invaluable service that a family doctor provides to his or her patient.
Brian Balmer
Chief Executive of North and South Essex Local Medical Committees Limited
