Mine was a two-partner practice that experienced a Care Quality Commission (CQC) inspection in March 2019, just prior to the COVID-19 pandemic. Thankfully, we were found to be good. We never managed to get the team party though as the first lockdown arrived even before we had our official result.
The following autumn my partner was forced to retire for reasons related to COVID-19, leaving us with no prospect of finding a replacement in the time. This left me single-handed from October 2020, though I was lucky to land excellent salaried help.
I was required to apply to the CQC to re-register as well as undergo a review by our CCG of whether to allow me to retain the practice contract at all: being single-handed is considered an automatic risk these days.
As a practice under ‘new’ ownership, we received a further inspection from CQC in November 2021, conducted remotely. We were found again to be good.
This year, my salaried GP agreed to partnership. I was overjoyed. It required that we applied to the NHS to change the practice ownership, again with the presumption that this was a wholly new enterprise. We similarly applied to the CQC, notifying them in February that my colleague would be my partner from April onwards. We understood from them that, as long as we did so at least a month ahead, that was sufficient notice.
My colleague and I signed a partnership agreement and at the start of April she became my partner. I don’t think there were balloons but there ought to have been.
As a practice under ‘new’ ownership, we suffered the strain of yet another inspection from the CQC in late April and the start of May, this time part remote, part in person. We were advised not to worry about the verdict, though we would need to await the report as usual.
Meantime, our application to register our new partnership kept being rejected. It was complex, involving three separate applications: we each applied to become partners in the ‘new’ organisation plus one of us — myself — to become the registered manager. Our errors were mostly because we had misunderstood the terms as used by the CQC Sale and Transfer Department. Its definitions have proved to be highly specific but not matching with common use in primary care.
Finally, a week after our inspection, I received an email indicating that the CQC were now considering our application to purchase the practice from myself. It stated: ‘You have confirmed that you are purchasing this location from Dr Saul Miller. CQC may need to contact the existing provider regarding this application, however we need your permission to do so.’ As bizarre as this request was, I duly gave permission.
Almost immediately, I received another email inviting me to apply to cancel my registration as a single-handed GP in charge of the practice, given that an application had been received to take it over. I submitted that application the following day.
Two days later — predictably — I received an email notifying me I had made multiple errors. It requested I submit corrections. Included was the warning ‘As the new provider has not yet been registered you must continue to comply with registration requirements up until that point. Please give a date in the future when you expect the completion of the legalities in order that we may prioritise our applications and work with your legal representatives.’
Accordingly, I responded with ‘corrections’ including the statement that I hoped to hand the practice over to the partnership on 31 May (a date plucked out of the air).
I have not yet been notified further: am I still officially single-handed? We are carrying on as if we have a valid partnership, looking after our patients. And on the plus side, the official report of the latest inspection has arrived. It says our partnership’s performance is good.
- © British Journal of General Practice 2022