The Care Quality Commission (CQC), the regulator of health and social care in England, released its annual State of Care report last week which found that a staggering 74% of the hospitals assessed under its new inspection regime have safety problems, with 13% rated as inadequate for safety.
On the face of it, this is an extremely concerning statistic for a 21st century healthcare system. However, on digging a little deeper, the picture is perhaps not quite as pessimistic as the numbers suggest. It seems these statistics relate to inspections of only 79 hospital trusts, about half the total number in England. It has also been pointed out that, of the hospitals inspected so far, many were targeted because of existing concerns which could mean that the figures may well improve as the new inspection process continues across the remaining hospitals. Further, of those hospitals deemed to be inadequate or requiring improvement for safety, concerns sometimes relate to a specific department within the hospital rather than the hospital as a whole (for example, while Queen’s Hospital (Burton) was rated overall as requiring improvement for safety, five of its eight services were in fact ranked as good).
That is not to say the report doesn’t present some very worrying findings. It highlights the ongoing need for improvements in patient safety, staffing levels and creating a culture of openness and honesty. It identified vast discrepancies between hospitals in the reporting and investigation of “adverse incidents” and the ability to share learning points and act on concerns. The report identifies insufficient staff numbers as one the major reason for failings in safety. However, with the nursing workforce in decline and junior doctors stating their intention to move abroad or leave the profession altogether if the recent proposed amendments to their working contracts (which they say will leave them significantly worse off financially) are introduced, it is difficult to see how hospitals will be able to improve on this.
Happily, it’s not all negative. The report does celebrate a number of excellent institutions where delivery of patient care was found to be outstanding. It also highlights the improvements made in some hospitals which have previously come under criticism and states that half of re-inspections across the health and social care sector have resulted in improved ratings.
However, we cannot ignore the difficulties our health and social care services are currently facing, with budget cuts, efficiency drives and the pressure for savings to be made across the board, all the while trying to provide a better quality service with dwindling staff numbers to an ever growing population with increasingly complex care needs. Without more support, hospitals are likely to face an immense challenge if they are to improve on this year’s ratings.