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12 Dec 2013

Inspectors reveal worst GP surgeries in England

Maggots in treatment rooms, out of date vaccines, and consulting rooms with no doors: inspectors reveal failings at some GP surgeries in England.

Maggots in treatment rooms, out of date vaccines, and consulting rooms with no doors: inspectors reveal failings at some GP surgeries in England. (G)

The Care Quality Commission (CQC) health regulator inspected almost 1,000 practices and uncovered a catalogue of failings, with medicines stored in a way that puts patients at risk of infection, and rooms so dirty they had maggots.

While many people were found to receive an excellent service, a third of the surgeries inspected (34 per cent) failed to meet at least one of the required standards on good practice and protecting patients.

The majority of practices inspected were singled out because of prior concerns. In nine practices “there were very serious failings that could potentially affect thousands of people”, the CQC said, and in 90 practices follow-up inspections had to be ordered to ensure improvements were made.

Some GPs were discovered leaving private medical files lying around, holding medicines that were out of date and employing staff who had not undergone criminal record checks.

You are talking about problems which can damage this generation and the next generation – Professor Steve Field

In one of the better-performing practices, inspectors found maggots and dirty conditions, while in another, consulting rooms had no doors and people could hear what was being said to the GP. In some surgeries, emergency drugs were out of date and fridges were not always checked to ensure they were at the right temperature.

The CQC said that these conditions put children in particular at risk because failure to store vaccines at the right temperature can reduce their effectiveness, leading to an outbreak of a contagious childhood disease such as measles.

At Dale Surgery in Sneinton in Nottinghamshire, inspectors found maggots and other insects, as well as dust and cobwebs. The surgery immediately sorted out the problem but inspectors said there was “no regular, effective and on-going monitoring of these standards”.

Out-of-date vaccines

The findings come as Professor Steve Field, the CQC’s new chief inspector of general practice, set out his new approach for the inspection and regulation of GPs and GP out-of-hours services. “We found some surgeries where there were out of date vaccines in the fridge,” he said, adding that people who wrongly think they are immune could become “very, very poorly and then die”.

He said a woman who thought she was immune to German measles due to vaccination could potentially give birth to a deaf and blind baby. “You are talking about problems which can damage this generation and the next generation,” he said.

Prof Field said patients also said that patients across the board had difficulties getting appointments. In one Birmingham practice, people were queueing outside in order to make an appointment, he added.

At another practice, both GPs had referred each other to the GMC for incompetence, while the inspectors turned up at one Leeds surgery to find that there were no GPs.

Hostile tone?

Dr Clare Gerarda, the former chair of the Royal College of GPs, described GPs as “the scapegoats for failures in the system”.

In a tweet to Professor Field, Dr Gerada said: “I worry that constantly focusing on the negative is undermining hard-working GPs and risks their mental state.”

In one of a series of tweets, Dr Gerada commented: “the problem we have is GPs are exhausted and expectations are rising – at lowest share of NHS budget for decades.” She added: “We can’t deal with what we see – I can’t. I end my surgeries with head in hands. exhausted.”

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