Safety report highlights “unacceptable” care

THERE is significant variation in the quality of healthcare in England and an "unacceptable level of poor care", according to a new report from the Care Quality Commission.

Between April 2014 and the end of May 2015, seven per cent of acute, primary medical and adult social care services were rated inadequate. More than one in 10 hospitals were rated inadequate for safety, alongside six per cent of GP practices and out-of-hours services.

The figures come 14 months into a new, tougher two-year inspection regime which is expected to be mostly completed by April 2016.

Almost 5,500 organisations have been inspected so far, including just under half of hospitals, 17 per cent of care services and 11 per cent of GP practices and out-of-hours providers.

The state of health care and adult social care in England 2014/15 report highlighted a number of incidents of concern including: A&E patients kept on trolleys overnight in a portable unit without proper nursing assessments; and staff at a GP surgery that had not had basic life support training in the previous 18 months.

It also highlighted more positive findings. More than 80 per cent of GP practices and six out of 10 adult social care services inspected by the CQC so far were rated as good or outstanding. Of the hospitals inspected, the figure was 38 per cent.

Excellent leadership and engagement with staff were found to be "more crucial than ever" when it came to providing good care in both primary and secondary care. The coordination of care at a national and local level was also seen to play a key role.

In its overview of primary medical services, the report said: "Our inspections have highlighted a strong link between good leadership and good care. Practices rated inadequate suffer from poor leadership.

"We have seen examples of poor incident reporting and a lack of learning from significant events, as well as evidence of poor medicines management."

It went on: "GP practices deliver a better quality of care when sharing learning and providing joined-up care through multi-professional networks. There is a need for GP practices to review access to medical advice and treatment to ensure they are in line with patients’ needs."

In terms of hospitals, the report said the factors separating trusts rated outstanding from those rated inadequate were their ability to "monitor and act on issues that are identified – promoting a culture of openness is important."

It raised concerns about the leadership and culture in many trusts, saying: "Consistent, good care throughout an organisation can only be achieved by excellent leadership and inclusive staff engagement. Safety remains our biggest concern for the sector, and staffing levels and skill mix remain an issue in many hospitals."

The CQC said the report showed they had been able to encourage improvement. Initial results from re-inspections so far suggested half of care providers had been able to boost their ratings within six months.

Those who had not improved were increasingly likely to face enforcement action – this happened in seven per cent of inspections in 2014/15 compared to four per cent in the previous period.

Commenting on the report, CQC chief executive David Behan said: "The variation in care that we have observed is not just about the money. 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."

Read the report on the CQC website