NHS hospitals face care inspection shake-up

26 Mar 13
Health Secretary Jeremy Hunt today announced changes in the inspection and regulation of NHS services following the care failings at Mid Staffordshire trust.

By Richard Johnstone | 26 March 2013

Health Secretary Jeremy Hunt today announced changes in the inspection and regulation of NHS services following the care failings at Mid Staffordshire trust.

Outlining the government’s formal response to the public inquiry into the trust, chaired by Robert Francis, Hunt said a new chief inspector of hospitals post would be created under the Care Quality Commission to detect problems in care.

Francis’s report, which was published in February, found patients at Mid Staffs’ Stafford Hospital were routinely neglected. Examining the care provided between January 2005 and March 2009, Francis said the most basic of needs, such as help with using the bathroom and eating and drinking, were overlooked.

Hunt said today’s reforms would put the quality of patient care at the heart of the NHS. The new chief inspector will introduce a performance rating for hospitals, modelled on the inspection regime used by Ofsted for schools.

Hunt also said that – following concerns that a single rating for a hospital could be misleading – measures would be developed for hospital performance at department level. This will allow cancer patients to find out about the quality of cancer services, and prospective mothers the standard of maternity services.

The chief inspector will also assess hospital complaints procedures and act as the ‘whistleblower-in-chief’ in the NHS by raising concerns about care quality.

A new chief inspector of social care will also be established to ensure the same rigour is applied in care homes, with performance rating also introduced in the sector.

Further reforms will also be made to the CQC to ensure it undertakes ‘rigorous and challenging’ reviews of both hospitals and care homes. Assessments will include judgements about hospitals’ overall performance, such as whether patients are listened to and treated with dignity and respect, as well as clinical standards and governance.

A new statutory duty of candour will also be introduced to place every organisation regulated by the CQC under an obligation to be honest and transparent when mistakes are made.

Hunt said these ‘radical’ measures were needed to change the health and social care system. 

‘The events at Stafford Hospital were a betrayal of the worst kind,’ he added. ‘A betrayal of the patients, of the families, and of the vast majority of NHS staff who do everything in their power to give their patients the high-quality, compassionate care they deserve.

‘We cannot merely tinker around the edges – we need a radical overhaul with high-quality care and compassion at its heart. Today I am setting out an initial response to Robert Francis’ recommendations.’

This would be just the start of a fundamental change to the system, he said, with further steps to be taken to introduce a culture of zero harm across the NHS. ‘And if something should go wrong, then those mistakes will be admitted, the patient told about them and steps taken to rectify them with proper accountability,’ he added.

Responding to the report, the NHS Commissioning Board pledged to use all its powers to ensure ‘everything the NHS does is driven by the best interests of patients’.

The organisation will take responsibility for monitoring how the NHS uses its £95bn budget effectively from April, following the government’s controversial reforms in the Health and Social Care Act.

Chief nursing officer Jane Cummings said: ‘We have to respond to Mid Staffs with clear action and not just with words in order to benefit all the patients who need our care.

‘The culture change we all want must be evident in every ward, clinic, consulting room and community setting, as well as every board room. It must run through the veins of a new NHS that is safer, more compassionate and constantly improving.’

Also responding, the NHS Confederation said that the whole health service ‘must keep a relentless focus on creating an NHS that is safer, more compassionate and fully accountable to the people it serves’.

Chief executive Mike Farrar said Hunt’s response found ‘the right balance between external assurance measures and internal changes focused on transforming the NHS culture’.

He added: ‘The NHS now has a real opportunity to do things differently, and it is the responsibility of all of us to make a real difference to the care provided to patients.’


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