‘Practices are being marked down on things they can’t do anything about’, says health boss about health inspectors
This is an edited version of an article first published by the Leicester Mercury
A GP practice manager has walked away from his role advising the Care Quality Commission (CQC) because he says the “regime” is driving hard-working GPs and staff out of the NHS.
Shaun Chadwick is the executive manager of eight practices in Leicester and a managing partner at a practice in Leicestershire, and was until recently acting as a specialist adviser to the CQC – earning £300 an inspection.
He said: “I’ve seen the CQC go from one standard to another. The previous chief inspector gave direction and practicality to the regime.
“The new methodology is all about targets, it’s driven by targets. This isn’t something that can be run that way. An inspection should be just that, an inspection, not a box-ticking exercise where ratings are given to meet targets. Practices are being marked down on things that they shouldn’t be and on things they can’t do anything about.”
Mr Chadwick, who said he was carrying out two inspections a week and sometimes more, is also business manager of two practices in Birmingham.
He said that practices are marked down on technical fails, one example included one surgery not saying it followed GDPR rules on its website – despite evidence of the rules being followed by staff. He gave other examples of some of the inconsistencies he said he has witnessed and experienced.
“At one of my practices there was a focused inspection because of the waiting list to see the nurse. There are no nurses, the government stopped the bursary, people stopped training and there’s a shortage,” he said.
“We had recruited a hospital nurse but there’s a lot of training required to come into primary care, that was underway, and the surgery was still marked down. GPs and staff are working 14/15 hour days, they don’t want to be but they do because their patients need them. Then on top of that they have inspections which are becoming increasingly inconsistent to worry about, it’s not fair. All of the GPs at my surgeries are kind, caring and hard-working. That is what patients need and want.”
Mr Chadwick, who is executive manager at Westcotes Surgery and Briton Street surgery, said that he has seen GPs and other clinical staff leave the profession because of the process and the pressures.
“People are being driven out of the NHS because of the way the CQC operates, this is not what it should be doing. If there are failures or problems at practices then they do need to be identified and addressed but in a way that is productive. The CQC has become counter-intuitive. It’s demoralising staff who are already up against it. They are working long days, long hours and propping up the NHS and then being criticised for things that aren’t their fault.”
After Mr Chadwick lodged his concerns, he says he was suspended and all of his practices were “immediately” inspected.
“I have taken a financial hit, I was earning maybe £600 a week for two inspections, but I can’t continue doing something I don’t think is right. I’ve walked away because I can’t carry on in that situation. I emailed the CEO, I tried to whistleblow, I tried to raise my concerns with management. I went to London to head office and I wasn’t allowed in, they wouldn’t give me an appointment.
“I felt like inspectors were being punitive, they weren’t following the ethos and they were penalising surgeries for technical issues that they deemed personally important. Some of my surgeries were pulled up on things that nothing would be said about at others. One would be told you need to do this and another would be told something else.”
Rosie Benneyworth, chief inspector of general practice at CQC, said: “The vast majority of GP practices in England are rated good or outstanding but we know that a small number have areas that need to be addressed, and we have seen many make constructive use of inspection reports to do. CQC remains committed to working with practices and helping them to improve the care they provide for people. This has not changed.
“Our inspections continue to follow a consistent approach and a clear methodology which was developed through consultation and conversations with the profession and is publicly available.
“Furthermore, they are carried out by dedicated and experienced inspection teams who work to make sure people have access to the safe, high-quality care that they deserve.
“Inspection reports are also subject to factual accuracy review from the practices themselves and are open to challenge before being published. These challenges, or any other, were not raised during factual accuracy or by the registered manager of Westcotes GP Surgery, and we will continue to work with them and the practice team in good faith as they work to deliver their clear vision for the surgery which we noted in our report.”
“We are confident that the rating of inadequate following an inspection in October 2019 was correct and will be carrying out a further inspection to check the required improvements have been made.”