Monday, 17 June 2013

Hospitals to undergo Ofsted-style inspections

Hospitals to undergo Ofsted-style inspections: Health watchdog sets out proposals to restore public confidence in the NHS Hospitals will regularly undergo tough two-week-long inspections and be given Ofsted-style ratings to revolutionise standards of care for patients, under coalition plans.

The government's health watchdog will set out how the current regime will be overhauled in the wake of a series of scandals that have damaged public confidence in the NHS. It is understood that the new system will be designed to provide patients with an easily understood barometer of the standards of care in their local hospitals.
Hospitals judged to be risking patients' health will be put into special measures – where experts force managers to change their habits, as happens now with failing schools.
The health secretary, Jeremy Hunt, believes the current system – under which trusts and care homes are merely told whether or not they meet certain minimum standards – encourages a "tick-box mentality" that leads to poor care.
The Care Quality Commission (CQC) will set out this week:
■ A new ratings scheme modelled on Ofsted schools ratings, with hospitals judged inadequate, requiring improvement, good, or outstanding.
■ A new failure regime that will see poor hospitals given a set period in which to improve before they are put into special measures.
■ A promise to patients about fundamental standards they should expect to receive when they enter a hospital.
A source said the CQC will consult on all details, but has been tasked by Hunt to move away from the current system in which hospitals are only judged on compliance with standards. Under the inspection plans, expert teams will use professional judgment, supported by objective measures and clinical evidence, to assess services.
It is understood the inspections of hospitals will vary in terms of what will be examined and will take as long as is needed, typically 15 days, with an average of six to seven days on site. In the vast majority of cases, inspections will be longer and more thorough than the CQC's current approach of a small team of inspectors on-site for one or two days.
A new failure regime will set out the three phases of action the CQC will engage in to identify and tackle serious problems with poor care in NHS trusts and NHS foundation trusts. These may be triggered by a specific incident but can also follow low ratings.
If the chief inspector of hospitals believes a trust requires significant improvement, the trust's board will be issued with a warning notice that requires the trust to improve within a fixed time period.
If the board is unable to resolve the problems, the chief inspector will formally request the healthcare regulator or the NHS Trust Development Authority to put the institution into special measures to protect people, to deal with the failure, and to hold individuals to account.
If care still fails to improve, the chief inspector will ensure a special administrator is appointed, suspending the board of the trust.
The move is in response to a major breakdown in public confidence in the NHS following the revelation that 1,200 patients needlessly died at Mid Staffs trust between 2005 and 2009. Hundreds of those cases are being investigated by police, who say there may be evidence of criminal neglect by staff.
A public inquiry led by Robert Francis QC reported in February that patients had been subjected to appalling suffering at the hospital, with failures at every level.
Since then, police and prosecutors, along with NHS regulators from the CQC, General Medical Council and Nursing and Midwifery Council, have been examining all 4,253 deaths at Stafford Hospital between 2005 and 2009.
Detectives are examining reports on care at the hospital, talking to the families of patients' families and scrutinising complaints, coroners' records and civil claims.
In its response to the Francis inquiry, the government will now also draw up a new set of fundamental standards of care for every hospital in the country.
It is Hunt's intention that the CQC will be able to prosecute breaches in these standards quickly and efficiently.
A consultation on the details of those standards will also be announced this week. The Guardian

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