Posts Tagged “CQC”
GPs are now legally required to have indemnity cover in following a Department of Health ruling to bring UK GPs in line with a European Union directive. Previously, GMC guidance stated that GPs were only required to have cover where necessary, the move comes at a time where the cost of indemnity cover is rising. An ANP in Weston-super-Mare has found her cover rising from under £900 last year to nearly £8000 this year despite there being no problems with her work over the last 12 months.
NHS Employers have said they will continue with plans to remove a supplement paid to GP trainees, which brings their pay in line with junior doctors working in hospitals, that could see GP trainees’ pay cut by a third. The RCGP has launched a petition to demand that the health secretary guarantees that GP trainees pay will not be cut. The implications of the new contract due to be forced on junior doctors have led to unparalleled numbers of doctors applying to the GMC to register to the certificates needed to work abroad. Tom Tugendhat, Conservative MP, has called for GPs to work for a set period of time, or pay off their training costs, before moving to work abroad. The proposed ‘return of service’ commitment would be similar to that of Armed Forces staff, for example, fighter pilots who have to serve 12 years before they are allowed to work in the commercial sector.
With the initial funding for the Government’s flagship 7 day access pilots due to run out this month, it transpires that 8 out of the 18 providers have either cut weekend or evening hours, or stopped running the service completely. Earlier this year, another 4 schemes reported similar changes meaning less than half of the pilots are still running as originally planned.
The Priory Avenue surgery in Caversham, Berkshire, one of the first practices to be placed in special measures, has now been rated ‘requires improvement’ following a re-inspection by the CQC. Meanwhile, Professor Field, CQC Chief Inspector has announced that practices rated ‘good’ or ‘outstanding’ may be inspected less frequently than every two years as planned.
The GPC has revealed its vision for the future of General Practice calling for practices to either federate into larger networks or build ‘super practices’ offering a range of services to patients. The GPC also called for the Department of Health and NHS England to increase GP funding, launch a campaign aimed at patients to reduce inappropriate appointment requests and establish an infrastructure fund to upgrade premises and technology.
Jeremy Hunt has called for all GP Practices to ensure their patients can access a 7 day service by 2020, even if they don’t provide the care directly themselves. Responding to a petition calling for a vote of no confidence in him, the health secretary said that doctors would realise 7 day access was “the right thing to do”. At the debate, which was amended to discuss contracts and conditions in the NHS, GPs were told they need to be ‘more flexible’ with regards 7 day access. Meanwhile, one of the Prime Minister’s Challenge Fund 7 day access pilots has been delayed owing to the length of time needed for CCG registration. NHS Cambridgeshire and Peterborough CCG planned to start the pilot in July but it is now expected that early morning and evening appointments will be phased in with most areas covered by late October.
The CQC has announced a change to the way it operates with aims to work ‘in partnership’ with healthcare providers and a ‘lighter touch’ approach. This follows a practice in Bristol which has successfully challenged the ‘needs improvement’ rating it received after its CQC inspection. The regulator admitted ‘due process’ had not been followed and the practice was rated ‘good’ on re-inspection.
A pilot scheme in London will provide careers advice to long-term unemployed patients in a bid to help them overcome health-related barriers to work. The ‘Working Better’ scheme launched at the beginning of September and is a joint venture between Islington Council, Jobcentre Plus and NHS Islington CCG. NHS England has also announced plans for firefighters to carry out basic health checks when visiting people’s homes to carry out safety checks. Pilot schemes will be run in Manchester, Staffordshire and Gloucestershire to test whether falls, broken hips and hospital admissions can be reduced.
London GPs are struggling to cope with demand and cite cuts to community staff, social services, mental health services and both an aging and increasing population as causes for the crisis. There are also 140 practices at risk of closure over the next three years.
Plans to extend GP training to 4 years are in doubt after comments made by Jeremy Hunt at a recent health committee meeting. The health secretary said that four year training would make it more difficult to meet the target of an extra 5,000 GPs by 2020. Meanwhile, the RCGP has called for training places in Northern Ireland to be nearly doubled from 65 to 111 as part of a range of measures it wants the Northern Ireland Government to examine.
The NHS Confederation has published a Primary Care myth buster to raise awareness that GPs already offer 7 day access. The move comes amid calls from academics for the Government to put a halt to 7 day access plans as research has not conclusively shown that 7 day access will reduce A& E admissions. Meanwhile, a small GP-led pilot scheme in Cornwall has reduced emergency admissions by 34% in a high-risk group of patients with two or more long-term conditions.
NICE has backtracked on its claim that 10million prescriptions for antibiotics every year are inappropriately prescribed. The figure was apparently based on ‘the far end of plausability’ of an estimate made by a single expert adviser.
The CQC is to make changes to the way it carries out practice inspections in order to improve the relationship between practices and inspectors. A named lead inspector for each CCG area will carry out the majority of inspections with visits spread throughout the year rather than during a 4 week window.
An error by NHS England has left 30 GP trainees in the Thames Valley and 14 in the West Midlands suspended from seeing patients for up to 3 weeks because they were not included on the performers list.
A survey of practice managers has found that 57% have applied for new jobs and many want to leave General Practice citing bureaucracy, poor pay, and a lack of training and opportunities for progression as reasons to look for management jobs in other sectors. Meanwhile, figures from the GMC show that on average, between 2008 and 2014, 2,852 certificates were issued to doctors enabling them to work abroad. Worryingly, it seems that the doctors most likely to leave are young, newly or recently qualified and without family or financial ties to the UK.
The NHS is seeking to recruit 200 US trained physician associates to four regions in the UK offering £50,000 for a 48 hour working week. The positions are for two years by which time, the first UK trained physician associates should be qualified.
Meanwhile, there are hopes that GPs will be amongst the groups to benefit from an increase on the expected pay rise of 1%. Groups with recruitment and retention issues may receive more than 1% according to the Treasury.
NHS England has announced plans for an emergency GP support framework comprised of 21 providers who will be pre-contracted to step in and take over the running of struggling practices at short notice. Amongst the providers 10 are GP-led organisations, there are also 2 NHS foundation trusts, small private companies and social enterprises as well as Virgin Care.
A survey has revealed that fewer than 30% of GPs would hire Physician Associates, with 40% ruling out employing them altogether. This will come as a blow to the Government whose ‘New Deal’ promised 1000 Physican Associates to be working in general practice by 2020. A recent advert for a Community Physician working across GP practices in Shropshire as part of the Government’s Challenge Fund seven-day GP access pilot provoked a backlash as it appeared to invite FY2 doctors to apply and work as an ‘unqualified GP’.
Part of the £1bn fund pledged towards improving GP premises over four years is to be used by NHS England to run the second phase of GP Access pilots. The news come after the fund has also been relieved of £10m to support struggling practices (part of the flagship ‘New Deal’ policy) and £15m to employ pharmacists in practices. Unrealistic expectations from patients and inappropriately booked appointments are adding to GPs workload, according to one GP, who has been asked to prescribe glasses, new shoes and ‘energy boosting medication’.
The health secretary has claimed that he has never met a doctor not in favour of 7 day working. However, he was subsequently challenged by Dr Emon Farrah Malik who told him he was ‘driving GPs out of the country’. Meanwhile, an anaesthetic trainee has started a twitter campaign highlighting that the NHS does run a 7 day service with the #ImInWorkJeremy hashtag. Simon Stevens, head of NHS England, has said that practices should not be forced to open on weekends if there is no demand for appointments.
GP Trainees in Wales are to be employed by the Government throughout their training in a move to encourage more doctors to enter GP Training. A pilot scheme was launched in April 2014 and the changes are set to be implemented as soon as possible. Newly qualified Welsh doctors choosing a career in General Practice will also have their medical school fees reimbursed as part of £4.5m of funding for primary care. Half of GP training places remain unfilled in some areas with a third round of recruitment to follow this year, this is the second year that a third recruitment round has been required. The RCGP has announced that it may allow some trainees to have a fifth attempt at the AKT or CSA in exceptional circumstances and provided candidates had ‘undertaken appropriate additional educational experience’.
Student nurses in Solihull are being offered placements in General Practice in order to generate more interest in the career. Six second-year students are being trained at six local practices to give them an insight into practice nursing and tackle the shortage of practice based nurses.
The controversial CQC inspections have proved beneficial for some practices rated outstanding who used the process as an opportunity to reassess ways of working, identifying weaknesses and ensuring information provided is up-to-date.