CQC admits ethnic minority-led GP practices are “not operating on a level playing field”

A report by the Care Quality Commission has found that certain inspection and monitoring methods may ‘inadvertently disadvantage’ ethnic minority-led GP practices, making it harder for these practices to achieve national targets.

This is because ethnic minority-led practices are more likely to care for populations with higher levels of socio-economic deprivation and poorer health, which also increases challenges around recruitment and funding.

The research was conducted after providers led by GPs of an ethnic minority background raised concerns that they do not receive the same regulatory outcomes from the CQC as providers led by GPs of a non-ethnic minority background.

Inspection results for ethnic minority-led GPs thought to be “harsh” and “unfair”

The report found that among ethnic minority-led GPs there was a feeling that CQC inspection outcomes could be “harsh” and “unfair” and that the health inspector didn’t understand or appreciate the unique challenges that ethnic minority-led practices face.

One survey revealed that ethnic minority-led practices were more likely to report that GPs in their practice experienced adverse impacts on their physical and mental health, a negative impact on their personal and/or family life, and had seen an increase in staff sickness as a result of the inspection process.

GPs from ethnic minority backgrounds also cited a lack of leadership support from external bodies, particularly as these practices are more likely to be run single-handedly – meaning they are operated by just one GP partner without other partners to offer support. This presented challenges around resourcing and capacity which can affect the ability of a practice to show how it is meeting regulatory requirements.

Some ethnic minority GPs also reported experiencing racism from patients, especially when patient expectations could not be met. They also felt patients were more likely to raise a complaint about an ethnic minority GP than a White British GP.

External factors can make it “harder to evidence the quality of care they offer”

The CQC admits that “internal or practice factors often have a disproportionate impact on practices where many ethnic minority GPs operate”, and there is now “work to do” to ensure they achieve their strategic and equality objectives and encourage practices that need support to improve.

Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at CQC said: “As the first port of call and foundation of most people’s health care, a huge expectation is placed on every practice team. However, what this report finds is that ethnic minority-led GP practices are often not operating on a level playing field in terms of where they work, and the support available to them.

“While the system still has work to do around robust, meaningful data collection and ethnicity, we need to respond to what we do know. It is clear from the experience of the GPs who spoke to us that the challenges they face can be magnified by factors which are outside of their control and make it harder to evidence the quality of care that they offer.”

RCGP glad the CQC have listened to their calls

The Royal Colleges of GPs (RCGP) say they are glad that the CQC has listened to their calls to investigate this matter, but there is still much to do to build the trust and confidence of all GPs in the inspection system, and particularly GPs from ethnic communities.

“It is essential that we see more progress on data linking ethnicity to ratings but acknowledge the efforts that CQC has made to explore the lived experiences of GPs and the recommendations it is proposing for its own organisation and the wider system. We now need swift action to put these recommendations in place so that inequalities can start to be properly addressed.

“We will continue to work constructively with CQC, NHSE and other relevant bodies towards an improved system of inspection that keeps patients safe and is supportive of all GPs, taking into account the specific challenges of GP teams working in ethnic minority-led practices,” said Professor Martin Marshall, Chair of the RCGP.