Thursday, 24 March 2011

The End? Almost, But Not Quite...

On Monday, I, along with a large number of BASICS doctors scattered across our nation, received a large, official-looking envelope. Upon opening it, we all found an identical letter, dated 16th December, 2010, along with a 100-or-so-pages form.

The letter was from CQC, the Care Quality Commission. They are the independent regulator of health and social care in England. What that means is that they ensure that anyone providing health care does so to an approved standard. All very laudable, I hear you say.

But now to the letter itself:

Dear RRD

As an immediate care doctor you and your organisation need to register yourselves with the Care Quality Commission. The enclosed form needs to be completed and back with us as soon as possible. If you have not sent in the form by April 1st 2011, you will need to cease all practice as an immediate care doctor, or risk facing prosecution under the Act, blah, blah, blah. Oh yes, and you need to pay us a whopping fee
to cover our processing costs. Oh, and there's a yearly fee for being on the register.

Yours sincerely

The Care Quality Commission

I may have paraphrased some of the letter, but you get the basic drift:  fill in the form & pay us the money, or stop doing your work.

Ok, I hear you say, surely this is all right and proper.  Who else is going to make sure that you all are properly trained and acting in our best interests, if not the CQC?  Who is going to stop the cowboys, those just out for glory, rather than those who care?  Agreed and agreed.  And, I was expecting to have to register with the CQC at some stage.  The last we had all heard was that we needed to be on the register by April 2012.  2012, not the week after next.

So, let's have a look at this form:

Please provide evidence to show you take the views of your patients into consideration when providing your service. "Excuse me, Sir, but I need to ask a few questions for my Patient Satisfaction Survey, before I intubate you."  Or, "Pardon me, Madam, but could you please tell me if you are happy with the colour of the cannula I have stuck in your arm, before I am able to give you any pain relief?"

Please provide details of every location where you provide your service.  If you haven't got enough space on the form provided, photocopy the relevant pages and send them off with the form.  Provide evidence that, at each of these locations, health and safety is considered.  Right, pass me a local A-Z.  And I'll just go and have a look and make sure there are no dangers lurking on the M25, shall I?

You can see my predicament.  Not only did they spring this on us, but they dated the letter December 16th, then sent it out in the middle of March! To everyone working in BASICS!!  Why the change?  Well, according to the letter, the Department of Health have advised them that immediate care work is outside the normal practice of the GP's.  Sorry?  Ok, there are a significant number of BASICS doctors who are general practitioners, but the Department of Health are unaware that there are a significant number of BASICS doctors who are not GP's, and who work in hospitals.

So, is that it?  Does RRD have to hang up his jump suit and boots?  Can Mrs RRD get a full night's sleep?  Not quite.  Fortunately, I have been able to get in touch with the Medical Director of my ambulance trust, who has agreed to include me in their submission... for now.  Watch this space.


  1. Sounds like a jolly good wheeze someone's come up with - let's bring in a compulsory register, at a nice price of course, and gouge ever more cash out of hard-working, dedicated people who're trying to ensure more people survive traumas. I wonder how many doctors will cease offering their services on the back of this (say, in rural areas where they'd need a large scale map) and how many members of the public will suffer. I'd say that I'm sure there's a really sensible reason behind this, but my mother taught me not to tell lies ...

  2. Every time I think my side of the Pond has a lock on bureaucratic nonsense, here comes the jolly old NHS to prove me wrong.

    Good luck...

  3. So, hold on a mo!

    You do this work for free as you get no funding from the Government, but in order to work for free, you have to pay from your own pocket, to an organisation that will simply place your name on a register - wahoo.

    Is this a scam? It certainly sounds like one. If not, it's tantamount to extortion....