In February 2021, CQC began work to examine concerns raised by some GPs that ethnic minority-led GP practices were more likely to have a poorer experience or outcomes from regulation than non ethnic minority-led practices.
While the limited data within the health and care system meant that it was not possible to establish any relationship between ethnicity of practice leadership and ratings, this work has identified contextual factors which can disproportionately affect ethnic minority-led practices and their ability to demonstrate how they provide good care.
Notably, ethnic minority-led practices are more likely to care for populations with higher levels of socio-economic deprivation and poorer health. This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding. GPs from ethnic minority backgrounds who contributed to this report also cited a lack of leadership support from external bodies.
Ethnic minority-led practices are also more likely to be single-handed - meaning they are operated by just one GP partner without other partners to offer support. This can present challenges around resourcing and capacity which can affect the ability of a practice to show how it is meeting regulatory requirements.
In response to this work, CQC will be reviewing and strengthening how it considers the context in which a GP practice works when it makes assessments about quality and ratings. The regulator will also take the learning and insight shared by minority ethnic GPs and inspection colleagues into its developing approach to assessing integrated care systems (a new duty placed on CQC by the Health and Care Bill).
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.
Everyone, wherever they are, has the right to safe, high-quality care and GPs should be supported appropriately to achieve this. We need to see a system response that acknowledges and reflects the context in which a practice operates - and is committed to understanding what this might mean for the way commissioners and regulators assess them. For this to be effective we also need to see clarity around the roles of these external bodies, including professional regulators and commissioners, in order to drive change and properly support people working in and cared for by ethnic minority-led practices.
You can read the published report on Ethnic minority-led GP practices: impact and experience of CQC regulation