But Who Cares For The Care Quality Commission?

Shit.

The Guardian
The Telegraph
The Daily Mail
All reporting on this State of Care publication, wherein the CQC has rated 61 trusts as ‘requires improvement’ for one domain: safe care, and 11 trusts as ‘inadequate’. This sounds super bad.
Here are some quotes:

Patient’s Association:

“It is worrying to see that there is still such variation in the quality of care being delivered.

This cannot continue. The safety of patients should be the primary concern of all healthcare professionals.”

Jeremy Hunt:

“There are some excellent examples of high quality care across the country but the level of variation is unacceptable.”

CQC:
“We are not saying 74% of trusts are unsafe. “
Oh. Hold on.

What’s the issue here- how are suddenly 3/4 of hospitals apparently ‘damned’. This doesn’t add up.
Have you ever read a CQC report? They make interesting reading.
Here’s the ‘safe care’ domain for Mersey Care Trust which achieved a ‘requires improvement’ for safe care. Points that meant that this hospital is classed as ‘failing’ by the Telegraph;
  •  it has reflective doors on an elderly care ward
  •  there are things to hang things off in the garden, which could be a hanging risk
  •  some audits aren’t finished off (these are mostly done by unpaid staff as additional projects btw)
  •  mental health is busy and some of the rooms need upgrading
And that’s it. Seriously.
Here is another ‘requires improvement’ safety report from Cambridgeshire and Peterborough, with the following ‘problems’.
  • ligature points (hanging risk)
  • three rooms in one department need upgrades
  • one team has vacancies
  • there is no out of hours learning disability service
  • occasionally one ward is short staffed
That’s it. That is the whole report on ‘safety’.
I could go on.
I’m not saying that the CQC isn’t serving a vital function- far from it. There are trusts here that fully deserve their ‘requires improvement’ moniker. Some have genuine problems with ‘never events’ and incident reporting. But this is getting lost in the noise.
I’ve compiled an analysis of 64 reports myself (i gave up at 64). I’ve rated every safety report on a different scale, using a professional eye. If there were less than six points for improvement on the entire safe care section I’ve classified it as ‘working’. If there are more than six but no actual patient harm, and all fixable within six months I’ve classified as ‘improving’. And everything else I’ve classified as failing.
Here are the stats:
  • % actually failing- 9.4%
  • % improving – 20.3%
  • % working – 70.3%
Here is the full spreadsheet: CQC.  (feel free to finish it off)
The commonest theme that emerged was a need for staff, in pretty much every trust. 71% of the total.
You can quibble with my methods- and please do. I’d be the first to admit they are awful. But the point still stands- if you look at the actual reports the CQC has published for ‘requiring improvement’ hospitals, there is little evidence to label them as ‘failing’.

When the CQC is your left hand, you should be  watching what the right hand, Monitor, is up to. They published this, this week, also in the Telegraph. In the name of  efficiency to save money, Monitor suggest we move some surgery from senior into more junior or even nursing hands. I am all for proper training by experience, but hospitals that did this would soon have the CQC come in and label them ‘inadequate’ as well. This two-pronged attack is genius really. The trusts are held at length, and then slapped about by both agencies- so eventually we can get to this. “The public isn’t as afraid of NHS privatisation as politicians think”. 15/10/15
This is the piece in the Telegraph that right alongside their headline ‘Hospitals are Failing’- it even has the same list of hospitals embedded into the online article. A puerile, poorly researched opinion, extolling the benefits of ending the state pay system, despite the fact that every other system mentioned in this article costs more money, by a factor of 30-100% of what the NHS costs, has poorer outcomes and are less equitable.
This, colleagues, contemporaries and fellow human beings is what the end game looks like.
The campaign against the junior doctor contract is now in full swing, but let us not forget what we are truly fighting: a corrupt government that has an ideological agenda to move public NHS services into private hands. The junior doctor contract is just a single step in a very long game, but one that is nearly up. We may still be able to do something about it.
Join the protest tomorrow, 2pm from Waterloo Place to Parliament Square, London.
Protect our patients. Protect our NHS.
Juniordoctorblog.com
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