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MPs hail hospital watchdog reforms

The hospital regulator is finally heading in the right direction after several years of "superficial" inspections into quality of care, according to MPs.

The Care Quality Commission (CQC) is now better able to protect patients and the public with a new system of inspections, the Commons Health Committee said. A "l ack of clarity and direction previously undermined the CQC's attempts to establish itself as an authoritative regulator", it added.

The CQC has been at the centre of a scandal over an alleged cover-up of baby deaths at a hospital in Morecambe Bay. CQC emails released under the Freedom of Information Act in October also revealed how the regulator had concerns about a Basildon trust in 2009 but "arguably sat on a highly sensitive safety issue for six months before informing patients and the public".

Today's Health Committee report follows an annual accountability hearing with the CQC.

Committee chairman, Tory MP Stephen Dorrell MP, said: "The CQC has been a case study in how not to run a regulator, but essential reforms implemented by the new management are turning the CQC around.

"The CQC has a renewed sense of purpose and now understands that it exists to ensure that care providers meet basic standards and to intervene when they do not.

"Putting in place systems to inspect hospitals and care homes proved too much for the CQC in previous years.

"Inspections were superficial and produced reports which bore little relation to reality, but the CQC now has a coherent plan to make sure providers are properly examined.

"Giving inspection teams the time and tools to understand what is really happening in hospitals, GP surgeries and care homes is fundamental. The CQC is now doing this by recruiting specialist inspectors who can understand and interpret what they observe during inspections."

The Health Committee praised a new Ofsted-style ratings system which will see hospitals given a mark of outstanding, good, requiring improvement or inadequate.

But Mr Dorrell added: "There are some providers where services are inherently high risk and where regular inspection is a vital component in maintaining the highest possible standard of care.

"Achieving an 'outstanding' rating should never mean that high-risk services are allowed to operate without oversight.

"Providers must not regard being awarded a positive rating from the CQC as a mechanism for escaping scrutiny."

Mr Dorrell also welcomed a move by the CQC to examine a much wider range of data relating to hospitals than before, with the idea of providing signals for early intervention.

"It is particularly welcome that the CQC will include data on staffing levels within the indicators and the Committee is keen that this should include key information such as the ratio of registered nurses to patients on hospital wards," he said.

"For the surveillance system to be successful the CQC must demonstrate that it can pick up on problems before they become known to the general public. If surveillance is perceived as slow, or reactive, it will not enjoy public confidence and credibility."

Mr Dorrell also welcomed moves by the CQC to cope with internal problems, such as high workloads for some staff and allegations of bullying.

CQC's chief executive, David Behan, said: 'I am pleased that the Committee has recognised that CQC is now better able to protect patients, people who use services and their families from the risk of poor care.

"The report notes the progress we are making in improving the way we regulate health and adult social care services and that we are clear about our purpose.

"I'd like to recognise the efforts and dedication of CQC's staff and the help we have had from our partners in bringing about these important changes. We will reflect on the Committee's recommendations and respond in full."

In a press conference, Mr Dorrell said monitoring staffing levels should ex tend beyond nurses to include midwives and doctors, especially in A&E units.

Breaches of the standards should automatically trigger inspections by the regulator, he added.

In November, ministers announced that hospitals in England would publish monthly figures on whether they have enough nurses on their wards.

There is to be no national minimum staffing standard.

Mr Dorrell said: "This should be applied across the delivery of health and care - doctors, midwives, practice nurses and social workers. Part of the difficulty in A&E is driven by the fact there is not enough doctors of all levels."

Labour MP Barbara Keeley said: 'Staffing levels are absolutely fundamental. It is ludicrous not to be transparent about something that patients and their families can see every day."

Mr Dorrell said the CQC overall "is largely an organisation that has and is addressing many of the issue that we have raised in previous reports. We are not yet saying all the challenges have been met. But by and large we agree with the management of the CQC about their objectives and we endorse them".

Norman Lamb, Care and Support Minister said: "The Francis report made it clear that the CQC needed to make radical changes to its inspection regime - this report shows that it is successfully rising to this challenge under new leadership.

"We asked for new chief inspectors to champion the needs of patients as well as larger, better qualified inspection teams who can identify risks and take tough action where standards aren't up to scratch.

"The CQC must now build on this and prove to the public that its surveillance is timely and effective for confidence to grow."


From Belfast Telegraph