Four out of five hospitals are unsafe, a new report by the Care Quality Commission (CQC) has found, with too many providers not getting to grips with the basics of safety. The commission laid the blame on poor leadership, saying that poorly led hospitals were almost always unsafe.
It ruled that funding could not be blamed as well-led services showed outstanding performances on the same resources as their failing neighbours. The report summarises the findings of a year’s worth of inspections undertaken under a new more rigorous and people-centred inspection regime.
Failures in safety included slips, trips, falls, medication errors and infections, with ‘never events’ – incidences that should never be allowed to happen, occurring at a rate of nearly one a day across the NHS. “This level of poor performance is shocking,” the report reads.
“This variation in the quality and safety of care in England is too wide and unacceptable. The public is being failed by the numerous hospitals, care homes and GP practices that are unable to meet the standards that their peers achieve and exceed.
“It is no excuse that this problem has existed for years – quite the opposite. CQC is calling time on this unacceptable lottery, and challenging every health and care provider in England, and every commissioner and oversight body, to deliver the high standards of care that each person has a right to expect,” said David Behan, chief executive of the CQC.
The Commission calls on patients as customers to be more discerning in where they go for treatment, and more demanding of higher standards where they have no choice on where they go. Behan urged the public: “use the information provided by CQC or by professionals who help you, to make decisions about your care and the care of your loved ones. Where you don’t have a choice of care, then become more demanding of those who should be acting in your interests. They should be putting you at the heart of good quality care. It is your right.”
An NHS hospital doctor agreed with the assessment, telling Breitbart London: “Reputation should be everything. I’ve lost track of how many people tell me such and such hospital is bad. GPs should now actively shop around for the best providers for their patients, especially if another NHS trust is better rated, and they should tell hospital bosses they are doing this. If we want change we have to vote with our feet.”
The report also calls into question the role of 15 minute ‘flying visits’ by care workers to vulnerable people in their homes. Last year charity Leonard Cheshire Disability found that up to 60 percent of councils use the 15 minute visits to deliver care to elderly and disabled people, and called for a ban on the practice which can “force disabled people to choose whether to go thirsty or go to the toilet”.
Care minister Norman Lamb said that the government couldn’t ban the visits entirely as they can be useful in some circumstances, such as when a carer visits someone to administer medicine. He did concede that the short visits were “completely inappropriate” when people needed feeding or bathing.
However, the CQC noted that it still has “concerns about whether 15-minute home visits can truly deliver care and support that is safe, caring, effective and responsive to people’s needs.”
With regards to GP practices, the commission inspected 30 NHS GP out-of-hours services, covering more than a third of England’s population, and found that most were “safe, effective, caring, responsive and well-led.” It did note, that larger practices were, on average, better at delivering quality care than small practices.
On hospitals, the commission prioritised the inspection of trusts deemed to be higher risk. It found that 24 of the 38 acute trusts inspected required improvement and five were inadequate. Just nine were rated good.
Of the 82 acute hospitals inspected, 49 were inadequate or required improvement in terms of leadership. Just one, Frimley Park hospital, was rated outstanding.
Although the healthcare staff were generally found to be compassionate and caring, leadership again came under fire and was urged to “make safety a priority and build a safety culture”, and “understand and discharge their own responsibilities for improving quality.”
In one example given within the report, an elderly nursing home resident was found to have been repeatedly left wet overnight, resulting in two urinary tract infections leading to increased confusion.” Indeed, she was so confused by them that she could not hold a conversation with anyone, including me,” the inspector wrote. “Staff actually thought it was just her level of dementia and were amazed at how different she was when she finally got over the infection.”
Health secretary Jeremy Hunt said that the report “exposes unacceptable levels of variation — exactly why we gave the CQC independence and why we’re confronting underperformance in the NHS as never before”. Earlier this week he highlighted that poor care cost the NHS £2.5billion a year in extra treatment.
The report finds that good leadership correlates more with safety than with any other measure.
Peter Carter, chief executive of the Royal College of Nursing, said: “This report correctly identifies strong and effective leadership as key to good quality care. This means ward sisters who have the time and resources to manage their staff, all the way up to trust boards who take an active interest in what is happening on the front line.”
Despite the NHS repeatedly being lauded as the ‘best healthcare provider globally’ and the ‘envy of the world’, a recent study by the Lancet ranked the UK 12 out of 19 countries in terms of years of healthy life the average person can expect to enjoy, and 13 out of the 19 countries for lifespan. Australia and Italy took joint first place, and Spain and Sweden joint second on lifespan.