Health secretary Jeremy Hunt wants to introduce a new Ofsted style rating system for hospitals and care homes to end the “crisis of care” in some parts of the system.
He has commissioned a review of how the system could work that will look at how data on performance and patient experience can be combined with information from Care Quality Commission inspections to produce a “useful, credible and meaningful” rating.
Nursing Times understands the ambition is to provide ratings for departments or even wards within hospitals, if possible.
The move reflects criticism that previous trust-wide rating systems, such as the Healthcare Commission’s annual health check or star rating systems, were too high level and could not give an accurate picture of care across a whole trust.
Mr Hunt officially announced the review on Wednesday in a speech to the think tank the King’s Fund.
He said: “In places that should be devoted to the patient, where care and compassion should be uppermost, we find its very opposite; coldness, resentment, indifference to human feelings – and in the very worst cases, like Winterbourne View, the unacceptable becomes legitimised and the plain cruel becomes the normal.”
The annual health check was fatally undermined in 2009 when the CQC intervened at Basildon and Thurrock University Hospitals Trust, which was then showing a “good” rating under the annual health check.
Mr Hunt said: “Parents know how well each school in my constituency is doing thanks to independent and thorough Ofsted inspections. But I do not know the same about hospitals and care homes.”
He added that there was a need for something that goes “further” than the friends and family test of patient experience, which is currently being rolled out, and the CQC’s essential standards.
Mr Hunt has stipulated that any new rating system should not increase bureaucracy, be easily understandable to the public and increase the chance of problems being identified before care failings like those seen at Mid Staffordshire Foundation Trust.
“There may have been problems with the way previous assessments were done, the people who did them, their timeliness or their accuracy. But the principle – that there should be an easy to understand, independent and expert assessment of how well somewhere is doing – is correct. And essential if we are to drive up standards,” he said.
Royal College of Nursing chief executive and general secretary Peter Carter said: “We know that Ofsted is a credible ratings system, which is respected by parents and users of the system. The RCN would support the introduction of a more comprehensive and robust system that can reflect the quality of services and the patient experience.
“We would like to see a more nuanced system than simply the ‘friends and family’ test that takes account of a wider range of factors and we look forward to seeing more details of this proposal.”
He added: “We know that as finances are squeezed, the quality of patient care is increasingly under threat. Increased transparency and more information for patients will help to ensure financial considerations do not override patient care. Equally, we know that there is no substitute for having the right number of staff with the right skills in hospitals and care homes.”