In its first State of Care report since the introduction of a new ratings system, the Care Quality Commission revealed that, as of 31 May 2015, 7% of acute, primary medical and adult social care had been rated as inadequate.
Safety was the watchdog’s biggest concern. The CQC said more than one in 10 hospitals and a similar proportion of social care services were rated inadequate for safety, alongside 6% of GP practices and out-of-hours services.
Strong leadership, collaboration and having the right professional mix in place was key to turning services around.
“The variation in care that we have observed is not just about the money,” said CQC chief executive David Behan.
“Good leaders are what make the difference – leaders who engage staff and people who use services and create a culture of continuous quality improvement... What is very clear is that isolated working and incremental changes are not going to be enough to meet the challenges ahead.”
However, the report included some positive messages, particularly given the challenging financial circumstances in both the health and care sectors.
More than 80% of GP practices and 60% of adult social care services inspected by the CQC have been rated as good or outstanding.
The proportion was rather lower for hospitals, with just 38% achieving the higher ratings.
Commenting on the report, Miriam Deakin, head of policy at NHS Providers, said: “NHS providers take seriously the areas for improvement set out within the report, and we note the need for a sustained focus on patient safety which is underpinned by robust governance and a culture of learning and improvement.”
She added that, in the current climate, regulation needed to be risk-based and proportionate.
Rob Webster, chief executive of the NHS Confederation, suggested the CQC start looking at health systems rather than individual organisations.
“No organisation is an island so we need a fundamental shift in the way we regulate care. We’ve seen some progress but more is needed. accident and emergancy performance, for example is a function of community support, social care and the local people as much as hospital staffing. Regulators should look at health and care systems not just individual organisations.”
Paul Briddock, the director of policy at the Healthcare Financial Management Association said that, given the £1bn overspent at the end of first quarter of 2015/16 reported by NHS providers, implementing further quality initiatives may now be simply out of reach without additional funding.
“The report’s finding that strong leadership is paramount to both driving up standards and balancing the books in today’s healthcare sector must be heeded by everyone involved in the sector,” he added.
“At a time when we are facing a potential exodus of employees in both clinical and non-clinical roles, the CQC’s report proves that strong, stable leadership directly contributes to providing the highest quality of patient care. We must do everything we can to keep talented leaders in our NHS.”
