Hunt vows to tackle hospital problems
The health secretary has promised to get “to the bottom” of problems in NHS hospitals after a review showed more than a quarter of trusts were at risk of not offering safe, high-quality care.
Jeremy Hunt said a new, “rigorous” inspection regime from the Care Quality Commission would identify those trusts that need to be sorted out, including placing them in special measures if necessary.
It comes as analysis by the CQC found 44 trusts out of 161 had the highest risks, including higher than expected death rates across their hospitals.
Some trusts were flagged for incidents resulting in harm to patients while others scored low on patient satisfaction or came to attention over whistleblowing staff.
The 161 acute trusts across England were examined by the CQC against more than 150 indicators.
The report will act as a screening tool to identify which trusts need the most rapid CQC inspections and where inspectors need to focus their attention.
Mr Hunt told BBC Radio 4’s World At One the figures were worrying but said “what the public should be reassured by is, first of all, we are never again going to have a situation where the NHS knows information that the public doesn’t”.
“Secondly, we have introduced a very rigorous inspection regime which means that each one of these hospitals will be inspected very soon and we will really get to the bottom if there is a problem, and if there is we will put them into special measures and sort it out,” he added.
“That is a world apart from what happened before, where ministers refused to have a public inquiry into Mid Staffs, where regulators were leaned on so they felt they couldn’t come out with bad news, where they abolished expert inspections so you had the same people inspecting hospitals as inspecting dentists - completely crazy.
“Really what we have got to do is be totally honest with the public about where there are problems and then sort the problems out quickly.”
In the CQC analysis, 161 trusts were divided into six bands, with band 1 being the highest risk and band 6 the lowest.
There were 44 trusts in the two bands with the highest risk, with 24 trusts in the highest possible band 1.
Some of these trusts are already in special measures, including Basildon and Thurrock University Hospitals Foundation Trust , Buckinghamshire Healthcare Trust, Medway Foundation Trust, North Cumbria University Hospitals Trust and Tameside Hospital Foundation Trust.
Alder Hey Children’s Foundation Trust in Liverpool has been identified as potentially high risk and sits in band 1. CQC inspectors working under a previous inspection regime said earlier this year the trust was meeting essential NHS standards.
Among five risks identified in the new analysis, three were regarded as “elevated risks” and related to whistleblowing, the quality of data submitted by the trust and staff concerns over managers.
Leeds Teaching Hospitals Trust, which runs Leeds General Infirmary, also passed essential standards last year and is listed in band 1. Concerns there include whistleblowing, cases of the bug Clostridium difficile and serious concerns over education.
At North Cumbria, 13 risks were identified, including 10 that were elevated. These included “never events” of incidents that should never happen in NHS hospitals, higher than expected death rates and issues over the time patients waited for treatment.
The CQC is using the data - called intelligent monitoring - to inform its new inspection regime of all NHS trusts by December 2015. It stressed today’s data was not a final judgment on the trusts.
Following detailed inspections, trusts will be given Ofsted-style school ratings of “outstanding”, “good”, “requires improvement” and “inadequate”.
The CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “As a doctor, I liken intelligent monitoring to a screening test; our inspection combined with intelligent monitoring provides the diagnosis, following which we make a judgment, which will in turn lead to action.
“Our intelligent monitoring helps to give us a good picture of risk within trusts, showing us where we need to focus our inspections.”
Mark Porter, chairman of the British Medical Association, said the data improved transparency across the NHS but many trusts were “buckling” under financial pressure.
“Hospitals are large, complex organisations so we need to avoid oversimplifying or reducing vast amounts of data to a simple band or rating,” he said.
“It goes without saying that where trusts are found to be operating below par we urgently need to identify where the problems lie and find a solution.
“The fact is many trusts are buckling under extreme financial pressure. The NHS is having to make £20bn of savings, leading to increasing pressure on staff and resources and, most worryingly, affecting patient care and outcomes.
“Many hospitals are stretched to breaking point.”
Mr Hunt admitted funding was “tight” but said some hospitals still maintained standards.
He said: ”Funding is tight across the NHS, it’s tight across the whole public sector. But what I would say is there are hospitals which have difficult financial challenges that are still delivering superb care.”
Christina McAnea, head of health at Unison, said the figures were a “shocking indictment of this government’s management of the NHS”.
She added: “Funding cuts, job losses and the impact of major, unnecessary structural reforms have left some parts of the NHS in chaos.
“Staff and mangers are working hard to deliver quality care for patients against a backdrop of a Government that seems more interested dismantling the NHS in England than improving patient care and safety.”
Shadow health minister Jamie Reed said: “David Cameron should be ashamed that he’s put so many of England’s hospitals in this position.
“He siphoned £3bn out of the NHS front line to blow on a back office reorganisation nobody voted for.
“Hospitals were left on a financial knife-edge and they are clearly struggling to maintain standards of patient care after more than three years of chaos.”
Jennifer Dixon, chief executive of the Health Foundation and CQC board member, said: “It makes sense to use the wealth of routinely available data in the NHS to try to spot patterns which might identify or predict poor-quality care for patients.
“The intelligent monitoring tool can never by itself be a crystal ball, but it is a great start and will surely develop over time.”