By Richard Johnstone | 12 February 2013
Health Secretary Jeremy Hunt today set out details of the government’s plans to overhaul inspections of NHS hospitals in England following the ‘disaster’ of failures in care at the Mid Staffordshire NHS Foundation Trust.
In a speech to the Reform think-tank, Hunt said the Francis report on the scandal showed the NHS had ‘failed’ in its basic duty not to harm patients.
The report exposed ‘a betrayal of patients’ and illustrated a need for ‘fundamental’ change to health watchdogs, he added.
Hunt confirmed that a new chief inspector of hospitals role would be created to ‘draw the multitudinous inspection regimes together and focus them on what is really important’.
These reforms would ‘put quality of care first, on a par with – or even more important than – financial stability’, he said.
If a hospital failed to provide a required standard of care, it would be placed in a revamped failure regime with tougher sanctions for managers.
‘At the moment, failure to meet Care Quality Commission standards simply does not have enough consequences for the management of a hospital.
‘Losing control of your finances matters, of course, but losing control of your care matters even more – and boards need to know that their jobs are on the line if they don’t sort out those problems.’
Hunt added the reforms also needed to avoid ‘the biggest trap of all’, which was to think that care and compassion ‘could be commanded from on high, either by regulators or politicians’.
Cumbersome bureaucracy and burdensome regulations were ‘a big part of the problem’. Hunt said he had asked Mike Farrar, chief executive of the NHS Confederation, to examine possible reforms. Farrar will report in March on whether joint inspections and better sharing of information between watchdogs could free up more time to care in hospitals.
Hunt’s speech followed the announcement by NHS medical director Sir Bruce Keogh that 14 hospital trusts were now going to be investigated for higher-than-expected death rates.
Following the publication of the public inquiry report into ‘shocking’ care failures in Mid Staffs on February 6, Prime Minister David Cameron asked Keogh to investigate care standards at hospitals with the highest mortality rates.
Keogh announced on the same day that he would examine the mortality rates at four foundation trusts in Colchester, Tameside, Blackpool and Basildon & Thurrock, and one trust serving East Lancashire. These hospitals had higher death rates than expected on the summary hospital-level mortality measure of deaths in hospitals, based on fatalities in up to 30 days after discharge.
It was announced yesterday that the probe would include another nine hospital trusts that were ‘persistent outliers’ according to a different indicator, the Hospital Standardised Mortality Ratio. This measures deaths in hospital based on certain medical conditions.
The nine additional trusts are: North Cumbria University Hospitals, United Lincolnshire Hospitals,George Eliot Hospital, Buckinghamshire Healthcare, Northern Lincolnshire & Goole Hospitals, the Dudley Group, Sherwood Forest Hospitals, Medway, and Burton Hospitals. The latter five are foundation trusts.
Keogh said that the hospitals were already working closely with a range of regulators. His investigation was to assure patients, public and Parliament that they understood why they had a high mortality rate and had all the support they needed to improve, he added.
‘This will be a thorough and rigorous process, involving patients, clinicians, regulators and local organisations.’
It would also provide practical support to any hospitals that need it, he said.
More details will be provided by the Department of Health on the timescale and terms of reference for Keogh’s investigation ‘shortly’. Keogh will invite regulators the Care Quality Commission and Monitor, as well as local Clinical Commissioning Groups, to be involved in the process.
