NHS standing on ‘burning platform’, warns CQC chief

The Care Quality Commission (CQC) has published the findings from its first round of acute and specialist hospital trust inspections, warning that ‘the NHS now stands on a burning platform’.

The report shows variation in the quality of hospital services, and claims that safety remains a key concern for hospitals, with many trusts showing a ‘failure to learn when things go wrong’.

The CQC has completed inspections of all 136 acute non-specialist and all 18 specialist trusts, and while the majority of hospital services are delivering good quality care and looking after patients well, inspections have also uncovered pockets of poor care even in good hospitals. The review found that, overall, 11 per cent were rated as inadequate on safety and 70 per cent required improvement.

The analysis supported the ongoing struggle of Accident and Emergency departments in handling increasing hospital attendances, as urgent and emergency services have received the highest number of inadequate ratings (nine per cent), followed by medical care on five per cent.

Conversely, critical care services and services for children and young people have received the most ratings of good and outstanding, sitting at 66 and 68 per cent respectively.

Professor Sir Mike Richards, CQC's Chief Inspector of Hospitals, also warned that staffing and overcrowding were major concerns and that unprecedented pressures on hospitals were putting patients at risk, with delays for patients getting tests and treatments, and poor care of life-threatening conditions such as sepsis.

Richards said: “We have now inspected every hospital in England and have a unique picture of the quality of care, right down to individual core services. We have found a wide variation in quality both between hospitals and between services within the same hospital.

“Safety remains a real concern, often due to a failure to learn when things go wrong. Strong leadership that instils a culture of learning and an environment where staff are listened to can play a vital part in bringing about improvements.

“What is clear is that while staff continue to work hard to deliver good care, the model of acute care that once worked well cannot continue to meet the needs of today's population. The NHS now stands on a burning platform – the need for change is clear, but finding the resources and energy to deliver that change while simultaneously providing safe patient care can seem almost impossible.”

Responding to the report, Niall Dickson, chief executive of the NHS Confederation, said: “Everyone knows that hospitals are finding it increasingly difficult to cope and this report again shows that well run institutions are struggling. It is now clear that A&E, in particular, is close to breaking point because the wider system isn’t sufficiently funded to keep enough people healthy nearer home.

“But money alone will not solve the problem - the current model is simply not sustainable and so we need to change the way care is delivered. There are already examples where new approaches are showing the way - the question is whether politicians will have the patience to give them time to develop and the courage to fund the system to cope with current pressures. If that happens we can work with staff, patients, users and carers to create a better way of delivering health and social care.”