Review of literature for ethnic minority-led GP practices: impact and experience of CQC regulation

Abstract

Background/aimThe Care Quality Commissions’ (CQC) recent report into the impact and experience of CQC regulation for ethnic minority-led general practitioner (GP) practices found that ethnic minority-led practices are disproportionately situated in areas of deprivation, working single-handedly and without adequate systems of support. These challenges are not always accounted for in CQC’s processes or methodology (CQC, 2022).This study summarises a review of literature carried out as part of research by the CQC, which was published in January 2022.MethodsSearch terms included ‘GP’, ‘CQC’, ‘Black and Ethnic Minority GPs’ combined with Boolean operators. Grey literature was reviewed, and searches were undertaken of known authors in the field. Backwards and forwards reference harvesting was performed on identified literature. Limitations included the capacity and subjectivity of the reviewer, as well as the availability of studies with a focus on ethnic minority GPs as opposed to doctors whose place of primary medical qualification was outside of the UK.Results20 evidence sources were identified and included. The literature review found that many ethnic minority-led GP practices are in complex cycle of inequality, which starts with recruitment and thereafter followed by deprivation, isolation, poor funding and low morale. The symptom of these factors is often poor regulatory outcomes and ratings. When these poor ratings are received, GP providers often struggle to recruit, which serves to perpetuate the cycle of inequality.ConclusionWhen CQC rates an ethnic minority-led practice as requires improvement or inadequate, this can perpetuate a cycle of inequality.

Responding to the systemic inequalities experienced by ethnic minority-led GP providers

“…This starts with ineffective recruitment systems and is thereafter perpetuated by further ineffective recruitment, deprivation, isolation, poorer funding and low morale (figure 1). 1…”