After news broke of the scandalous care standards at Stafford Hospital, the Care Quality Commission (CQC) came under attack for not identifying fundamental shortcomings in the hospital’s standards and the deaths that ensued. The CQC necessarily underwent a major review of its inspection procedures to work out why so much seemed to have been missed.
The outcome has been to refocus CQC inspections on key service areas which the CQC believes will enable it to assess what it describes as the 'whole patient experience' and to expose poor quality care.
The first inspection under the new regime begins today (17/09/2013) at Croydon Health Services NHS Trust in South London. A team led by Professor Sir Mike Richards, Chief Inspector of Hospitals, will comprise a range of clinicians from experienced surgeons to trainee nurses, as well as members of the public.
The inspection team will spend one day at Croydon University Hospital assessing eight key departments including A&E, surgery, critical care, outpatients, maternity, paediatrics and end-of-life provision. The previous inspection regime focussed on specific standards such as infection control rather than the overall system across each of these departments. Some inspections will be notified in advance, others will turn up unannounced and there will also be weekend and evening inspections.
Gauging patient experiences is integral to the new focus and a key part of each planned inspection is a local community meeting at which members of the public can feed their views and experiences into the CQC's understanding of the care delivered by each trust. The first such meeting will be held at local Fairfield Halls in Croydon on the same day as the inspection.
The timetable is a gruelling one with the second inspection following just two days later in Scotland and 18 inspections planned by the end of the year. The CQC also has the power to take various enforcement actions and has to factor in the time to impose and monitor those actions alongside the inspection schedule.
Welcoming the expanded scope of the inspection regime, Andrew Clayton, associate in the clinical negligence team at Penningtons, commented: "Key lessons from Stafford and elsewhere include the recognition that patients and their families have been ignored or marginalised in decisions about care needs and provision, in some cases with fatal consequences. A shift in emphasis to embrace patients' and relatives' input as part of healthcare provision can only improve things.
“The CQC's move to evaluate those views in its inspections is commendable. The hope must be that those hospitals that, after Stafford, are not already taking greater account of patients and families in their decision-making will now face significant pressure to do so. The CQC presents an ambitious programme and there is clearly pressure to deliver improvement quickly. Only time will tell whether this can accomplished with such intense and short inspections and whether these will carry sufficient weight to avoid the catastrophic failings of the recent past."