Mark Copsey, divisional director at Howden Health and Care, says that a reduction in inspection times would enable clinics to trade to their full potential.
Small, independent clinics seeking to register with the Care Quality Commission (CQC) and receive their first rating are being impacted by backlogs in the regulator’s inspection regime.
The people who are setting up these clinics are being very proactive – they have spotted a niche in the market and want to fill it. They are going through the CQC process, and it is just taking months and months.
This year alone, I have had at least ten clients wanting to set up a new service or create a business and they are having to wait up to 12 months between submitting their application and being given the green light to open.
It is a real concern for them. They are looking to provide valuable healthcare services in their local communities. They want to make people better, but they are being prevented from doing that.
We speak to these customers to arrange their public and employers liability insurance – a CQC requirement ahead of applying to register.
The CQC tells clinics that they need to have policies and insurance in place to be considered for inspection, but visits are not happening until six to nine months after applying, which is jeopardising the physical risk for clinicians looking to head into private practice for the first time.
While clinics are waiting for their inspection, they not only have the cost of insurance premiums, but are also paying for bank loans and lease agreements, all the time being unable to generate any income.
The problem of unoccupied premises
To sign a lease agreement, they need to have their property liability cover in place, but the premises can sit empty for up to eight months before the inspection is even carried out. This does impact the healthcare provider from an insurance point of view because, if that premise is unoccupied, that can jeopardise the cover.
Clinic operators are hopeful that they can get their registration within 12 months of applying. However, the CQC is getting more applications than ever from those seeking to offer services that the NHS currently does not provide, and people looking for a private practice opportunity.
This delay is leading applicants to become increasingly frustrated and demoralised with the whole process, and a lot of people consider giving up. Most do persist, though, and eventually they are able to fill that niche in the market, which has the potential to help a lot of people who wouldn’t necessarily be on NHS waiting lists.
Firms like Howden can help mitigate insurance costs by issuing letters of intent, stating to the CQC that it is willing to insure healthcare providers, and cover will be in place by the time registration is approved.
This would help new clinics immensely, saving them costs and time. While this might ease the outgoings of would-be healthcare providers, accepting this guarantee is down to the discretion of individual inspectors.
Clarity needed
Healthcare providers need clarity over when they can expect their registration to be confirmed. Could the CQC not refine their process to say “let’s get the application in before you even think about premises”? That takes it into a six- to eight-month parallel conversation rather than everything having to be done in advance.
They will be legally obliged to have this insurance in place once operational, as they would not be able to trade without it.
It is not just registration backlogs which are impacting healthcare providers. Delays of up to five years when attempting to obtain a CQC rating via a post-registration inspection are causing problems too.
A positive CQC rating is essential for providers as patients and NHS-Trusts now use inspection reports as a tool when selecting the best clinics for their needs.
For many clinics, having to patiently wait for an inspection has the potential to harm their business. Reducing inspection times would not only alleviate this risk but would enable the clinics to trade to their full potential, improving the health of people in their local area.
