Checks on 1,000 practices across England exposed "serious failings that could potentially affect thousands of people".
Inspectors have uncovered a catalogue of failings at GP
surgeries - including one with rooms so dirty it had maggots on the
floor.
The Care Quality Commission (CQC) health regulator carried out
inspections at 1,000 practices across England, and found examples of
"very poor care" that put patients at risk.In nine practices it found "serious failings that could potentially affect thousands of people", and follow-up inspections had to be ordered in 90 practices to ensure improvements were made.
At Dale Surgery in Sneinton, in Nottinghamshire, inspectors found maggots and other insects, as well as dust and cobwebs.
The surgery immediately dealt with the problem, but inspectors said there was "no regular, effective and on-going monitoring of these standards".
Professor Steve Field, the CQC's new chief inspector of general practice, said: "We can talk about the fact we found maggots in a treatment room.
"And when we asked the question - and this is a good practice - the nurse said yes we do seem to have a bit of a problem. But they sorted it straight away."
Some GPs at other practices left private medical files lying around, had medicines that were out of date and filthy treatment rooms, and employed staff who had not undergone criminal record checks.
In some surgeries, emergency drugs were out of date and fridges were not always checked to ensure they were at the right temperature.
While many people received an excellent service, a third of surgeries (34%) failed to meet at least one of the required standards on good practice and protecting patients.
Prof Field has set out a new approach for the inspection and regulation of GPs and GP out-of-hours services.
His new-style inspections will start in April 2014 and will involve a CQC inspector, a GP, a practice nurse or practice manager and a trainee GP.
Inspectors will visit every clinical commissioning group region in England once every six months, inspecting a quarter of the practices in that area.
Every practice will have been inspected by April 2016 and given Ofsted-style ratings.
From January, new inspections will also focus on GP out-of-hours services.
"We need to make sure that everyone, from the most well-off to the most disadvantaged, can get access to really good primary medical care," he said.
"This is something which I intend to champion as chief inspector. When something goes wrong in general practice, it has the potential to affect thousands of local people."
Dr Maureen Baker, chairwoman of the Royal College of GPs, said: "Specific areas for improvement have been found and the CQC must now work with these practices to ensure that they meet the necessary standards and that other practices can learn from their experiences."
Dr Chaand Nagpaul, chairman of the British Medical Association's general practice committee, said the BMA was committed to improving standards.
"It's important, however, that anecdotes of poor practice are not used to distort the reality, which is that the overwhelming majority of hard-working GPs provide high-quality care which is appreciated by patients," he said.
Health Secretary Jeremy Hunt said: "Patients have a right to expect the best care from their GP practice."
