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Inspections of GP practices, the ‘Intelligent Monitoring’ scheme
As you’ll have seen in the media the Care Quality Commission (CQC) recently announced the findings of its ‘Intelligent Monitoring’ scheme, assessing all GP surgeries in England.
The report assigned risk ratings to GP practices based on data from the Quality and Outcomes Framework (QOF). Practices were assessed against criteria of 38 indicators, these included giving out of date medicines and a lack of practice nurses along with badly documented areas of practice. Based on the outcomes practices were placed in one of six bands, with high risk practices finding themselves in band one or two.
As you can imagine, the initial finding and report caused debate amongst patients and the general practice community.
Dr Richard Vautrey, deputy chair of the General Pharmaceutical Council (GPC), was commented as saying the findings were “simplistic†judgments, potentially misleading and likely to confuse patientsâ€
The report highlighted 16% of all GP practices were in band one or two, so the highest risk surgeries. These are surgeries seen as needing the most intervention, they will be first in line to be visited and assessed. However, since the data’s initial release an independent investigation by the BBC discovered that in some areas the data used was indeed flawed and it believed many practices had been banded incorrectly.
This clearly shows there is a risk when using such data alone as a performance indicator; it is too open to interpretation to offer a true view of the risk for certain GP practices. Given that the CQC has since revisited and reviewed the data and subsequently reported 60 practices (which represent 1% of all practices) will be moved from bands one and two into lower bands. It is therefore a reasonable conclusion to draw that some practices will be moving into the high risk bands that previously were not flagged.
Like many previous reports, this data is just one of many tools used to access NHS services. There is lots of other data available to draw conclusions rather than relying solely on the its ‘Intelligent Monitoring’ scheme.  Starting with the launch last month of “MyNHSâ€, a tool that allows professionals and patients to assess the health services available to them through using a wide range of data and criteria. The data available through the new tool is more varied and detailed; it looks a statistics on individual surgeons, hospital performance, public health and mortality rates, all previously available to the public but perhaps not so accessible.
Health Secretary Jeremy Hunt said the MyNHS tool “uses the power of learning culture and of peer review, not blameâ€.
Reading the press and media on this very topic, the overall opinion is that the results and data misleads patients and is “meaninglessâ€. So, with the constant reports on the failings of the NHS and in particular GP practices how can we ensure that the public remain confident in their local GP surgery?