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Review of literature for ethnic minority-led GP practices: impact and experience of CQC regulation
  1. Annabelle Stigwood1,
  2. Ayisha Adeeba Ashmore2,
  3. Devina Maru3,
  4. Lakshya Soni4
  1. 1 Implamentation Manager, Care Quality Commission, London, UK
  2. 2 ST4 Registrar, University Hospitals of Leicester, Obstetrics and Gynaecology Department, Leicester, UK
  3. 3 National Medical Director's Clinical Fellow, Primary Medical Services and Integrated Care Directorate, GP Specialty Registrar, London, UK
  4. 4 Junior Doctor, Queen Elizabeth Woolwich, London, UK
  1. Correspondence to Mrs Annabelle Stigwood, Inequalities Project Co-Lead, Primary Medical Services and Integrated Care Directorate, Care Quality Commission, London, London, UK; Annabelle.Stigwood{at}


Background/aim The 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.

Methods Search 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.

Results 20 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.

Conclusion When CQC rates an ethnic minority-led practice as requires improvement or inadequate, this can perpetuate a cycle of inequality.

  • GP
  • regulation
  • primary care

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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  • Contributors AS planned and led the study. She completed the initial literature review and initial draft. AAA reviewed and edited the initial draft and subsequent drafts thereafter. DM and LS reviewed and edited to the manuscript at various stages of the drafting process.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AS is employed by the CQC. DM is on secondment with the CQC. AAA was previously on secondment with the CQC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.