England's worst GP surgeries named and shamed – so is YOURS one of them?

GP Surgery Performance Concerns: Nearly One Third Fail to Meet Standards in Some Areas

New analysis reveals that almost a third of GP surgeries across certain regions of England are underperforming. A comprehensive review of over 6,000 general practices nationwide by MailOnline indicates that 28 have received the lowest possible rating of ‘inadequate’.

Furthermore, the Care Quality Commission (CQC), the health regulator, has identified an additional 288 practices that ‘require improvement’.

Regional Disparities in GP Care Quality

This investigation exposes a significant postcode lottery in patient care. MailOnline’s findings show that in Barking and Dagenham, a concerning 29.4 percent of GP surgeries are failing to meet expected standards.

Similarly, Medway in Kent exhibits a high proportion of subpar practices at 24.2 percent, with Greenwich in East London closely following at 19.4 percent.

Interactive Tools to Explore Local GP Performance

Detailed results from MailOnline’s investigation can be explored through interactive maps. These resources illustrate the overall performance of GP surgeries in specific localities and provide individual ratings for each practice.

Understanding CQC Inspection Ratings

The CQC employs a tiered inspection system, with the frequency of evaluations determined by a practice’s current performance level.

Practices are categorized using a color-coded system akin to a ‘Nando’s-style’ scale:

• Outstanding (Blue): Representing the highest level of performance.
• Good (Green): Meeting expected standards.
• Requires Improvement (Amber): Indicating areas needing enhancement.
• Inadequate (Red): Signifying serious concerns and potential enforcement action.

Surgeries rated ‘outstanding’ are inspected every two and a half years, while ‘good’ practices are assessed at least every two years. Practices needing improvement or deemed inadequate face more frequent scrutiny, sometimes as often as every six months.

Key Areas of CQC Assessment

The CQC evaluates GP practices across five domains:

• Safety: Ensuring patient safety and well-being.
• Effectiveness: Assessing the efficacy of care and treatment.
• Caring: Evaluating the compassion and consideration shown to patients.
• Responsiveness: Measuring how well services meet patient needs.
• Leadership: Examining the governance and management of the practice.

Local Authority Performance Breakdown

In Barking and Dagenham, London, two out of 34 facilities were judged ‘inadequate’. This designation means “the service is performing poorly, and we’ve taken action against the responsible party.” A further eight surgeries in the area ‘require improvement’.

Exceptional Performance and Specific Cases of Concern

The Isles of Scilly stands out as the only area with all GP surgeries achieving an ‘outstanding’ rating, although it has only one practice.

Among ‘inadequate’ rated surgeries, Blossom Health in Gosport drew criticism for inappropriately prescribing pregabalin to women of childbearing age without adequately informing them about the potential risks to pregnant women. Pregabalin, used for anxiety and epilepsy, has been linked to potential birth defects.

Another surgery, The Whitestone Surgery in Nuneaton, was recently managed by locum doctors following the suspension of its lead GP by the General Medical Council (GMC). The GMC’s action followed concerns from the CQC that the GP’s continued practice posed a significant risk to patients. The Coventry and Rugby GP Alliance is currently overseeing the practice in a caretaker capacity.

Data Currency and GP Contract Reforms

It is important to note that the CQC data is current as of March 3, 2025. Ratings may have changed since this date due to subsequent inspections.

Following a period of negotiation, GPs have agreed to new contract reforms aimed at revitalizing the ‘family doctor’ model. Government ministers hope these reforms will alleviate appointment booking issues, enabling patients to schedule appointments online throughout the day, moving away from the traditional 8 am phone rush.

The new contract, valued at nearly £900 million, also seeks to reduce bureaucratic burdens on GPs, such as reporting requirements on staff wellbeing meetings.

Factors Contributing to GP pressures

The appointment challenges are exacerbated by a growing population and a shrinking GP workforce. An increasing number of doctors are choosing to reduce their working hours or retire early. Some are opting for private practice or positions abroad, citing mounting pressures within the NHS.

However, healthcare professionals suggest the issues extend beyond staffing and patient numbers.

Perspectives from the Frontline

Dr. Vikram Murthy, a GP at the ‘good’-rated Reach Healthcare Centre in Kent, described general practice in the UK as being ‘at the cliff edge’.

He stated, ‘The resource scarcity is pervasive, most evident in the ‘Hunger Games’-like 8 am call rush. The current situation is significantly worse than in previous generations when a single GP served around 1,500 patients – now it can easily be 6,000 or more.’

Dr. Murthy acknowledged that initiatives from Health Secretary Wes Streeting and the British Medical Association to ease GP pressures could offer short-term relief, but emphasized an ongoing recruitment crisis. He noted that junior doctors and medical students are increasingly choosing hospital roles due to perceived stability and clarity.

‘A concerted effort is needed to make general practice and primary care a more attractive career path,’ he urged.

Patient Advocacy Group Response

Dennis Silver of Silver Voices, an advocacy group for the elderly, expressed that the concerning ratings were not unexpected. He commented, ‘There has been considerable rhetoric but insufficient tangible action to improve lives.’

He added, ‘Wes Streeting prominently announced the new GP contract last month, suggesting it would reduce bureaucracy, allowing doctors to focus on patients and return to the “age of the family doctor”. However, the government and doctors need to clarify their vision of “a return to the family doctor.” This should imply consistent care from a regular doctor, which remains far removed from the current reality for many patients.’

Royal College of GPs’ Stance

Professor Kamila Hawthorne, Chair of the Royal College of GPs, stated, ‘GPs and their teams are managing millions more appointments monthly compared to five years ago, with only a marginal increase in fully qualified, full-time GPs. We have repeatedly voiced concerns that this situation is neither safe for patients nor sustainable for practices.’

‘Despite these pressures, almost 95 percent of GP practices in England are currently rated good or outstanding. GPs and their teams are working tirelessly to provide safe and timely care. Where patient safety concerns arise, it is crucial that practices receive support for improvement rather than condemnation, prioritizing patient welfare.’

‘Patient safety is paramount in general practice. The College recognizes that effective and proportionate inspections can contribute to patient safety and support struggling practices.’

‘However, independent reviews have raised significant concerns regarding the CQC’s current inspection methods. Our governing Council has advocated for pausing routine inspections until improvements are enacted and for moving away from “one-word” ratings. We propose alternative assessment methods that consider the specific circumstances of individual practices and enhance transparency and support for both patients and professionals.’