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GP ratings would be misleading

GP ratings would be misleading
27 March 2013

Concerns have been raised over the ‘Ofsted-style’ rating scheme launched by the government by various GP leaders groups, including the Royal College of GPs (RCGP). 

Concerns have been raised over the ‘Ofsted-style’ rating scheme launched by the government by various GP leaders groups, including the Royal College of GPs (RCGP). 

Although the speed with which the government responded to the Francis report was lauded, RCGP the British Medical Association (BMA) and the King’s Fund feel the scoring system is “questionable” and could be “misleading”. 
No ‘meaningful comparison’ 
A system which rates general practices would be simplistic, RCGP chair Dr Clare Gerada suggested. 
She said: “We believe it would mislead patients, rather than helping them to assess the quality of GP practices in their area. 
“A single summary score is unlikely to take into account the age of the practice population, deprivation, or a whole host of other factors, and will therefore be unable to offer meaningful comparisons.” 
The BMA also believes the rating system could be misleading and said that a system which unduly focuses on ratings needs to be avoided, 
“It’s important that patients have access to information about the quality of services,” said BMA council chair Dr Mark Porter. 
He added: “It is vitally important that we do not allow a ratings system to create a misleading picture of any hospital department or GP practice. This would be unhelpful to patients, as well as demoralising to staff.” 
Dr Porter said that most healthcare providers are “extraordinarily complex organisations” and it would be hard to reduce them to a single score. 
Chris Ham, chief executive of healthcare research organisation The King’s Fund agreed that hospitals could be too complex to rate. 
“The value of aggregated ratings for hospitals is highly questionable; these are complex organisations with different services and specialisms that may vary in quality so an overall rating can hide significant failings within a trust.” 
However, The King’s Fund believes that proposed ratings for specific services would be of “much greater value”. 
‘Culture of zero-harm’
A plan of action is needed to show how the government will enforce a ban on gagging clauses, according to the RCGP.  
Dr Gerada said the government “needs to consider what measures are needed to ensure NHS whistle blowers are better able to access practical and financial support."
A “culture of zero harm” will not be possible without staff feeling about to speak freely, the BMA have said. 
The BMA shares Health Secretary Jeremy Hunt’s concerns that the threat of criminal sanctions for individual staff would be “counterproductive and risk creating a new climate of fear”. 
Dr Porter said: “Doctors already have clear professional duties to raise and act on concerns about patient safety.  
“On the rare occasions when they do not, it is often because they are afraid of harassment by employers or colleagues.” 
‘Sharper focus’ 
The Care Quality Commission (CQC) has announced it will change the way it inspects so that it will “focus on the four key areas that are most important to people.” 
In future the CQC will be focussing on: 
How well hospitals are care homes are led.
CQC Chief Executive David Behan said: “We will introduce expert inspection teams that include specialist inspectors, clinical and other experts, and people with experience of care. 
“We will also introduce national teams with specialist expertise to carry out in depth reviews of hospitals with significant or long standing problems.”
CQC has also committed to using data, intelligence and evidence in a more sophisticated way, so that it identifies, predicts and responds to varying standards of care more quickly.
It has also committed to listen better to people’s experience of moving between different services, work better with other regulators and partners to share information and evidence and coordinate our inspections and activities and publish better information for the public, including the new ‘Ofsted-rating’. 

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