29 November 2002
The Commission for Health Improvement said this week that the north-south divide had been revealed by the 175 inspections it had performed in the two years since it was established.
Chi assesses trusts' clinical governance – the management of the quality of patient care – and found that inspectors raised fewer concerns about those in the north and midlands.
These trusts also tended to get higher scores on Chi's appraisal of the seven components of clinical governance, which include risk management, patient involvement and clinical audit.
Chi chief executive Peter Homa said difficulties in recruiting staff – one of the main reasons given by trusts in the south to explain poor performance – contributed to the pattern. But lack of flexibility was also a factor.
'From our inspections a clear picture is emerging. NHS bodies in the north and midlands have better working systems in place to deliver high-quality care than those in the south. There may be many reasons for this variation, associated with difficulties recruiting staff and differences in culture or attitude,' he added.
He also drew attention to common failings revealed by the inspections. More than 80% of trusts reacted to problems rather than taking a proactive approach that could anticipate and avoid difficulties. They failed to share what they had learned, both within their own organisation and with other trusts, while communication between professional groups and managers was poor.
Homa was also concerned about the regularity with which trusts were failing on four of the clinical governance components – risk management, staffing and staff management, patient involvement and use of information.
But there were examples of innovative improvements in patient experience and care, he added. Bromley Hospitals Trust had reduced the number of visits cardiac patients made to hospital and cut the time between referral, diagnosis and treatment by introducing a rapid access clinic.
Homa also praised Dewsbury Healthcare Trust's telephone reporting system for serious incidents. The system was convenient for staff to use and the trust's analysis of the information was thorough, he added.
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