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Staff at 'inadequate' trusts worst for reporting patient harm

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Staff working at acute trusts that are rated as “inadequate” by the Care Quality Commission are significantly more likely to witness harmful errors but less likely to report them, according to the regulator.

The CQC mapped the latest staff survey results against its overall rating of each hospital trust. It found that 34% of staff at “inadequate” trusts said they saw potentially harmful errors, near misses or incidents in the last month.

This was 7 percentage points higher than at “outstanding” trusts, and 4 percentage points higher than at trusts rated “require improvement”. The staff survey was carried out between September and December 2016.

The percentage of staff saying they reported errors or near misses in the last month was almost equal between both “inadequate” and “outstanding” trusts, with 89.8% of staff reporting concerns in the former and 89.7% in the latter.

The data also showed that, while the number of staff witnessing potentially harmful incidents falls as the rating of a trust improves, the reporting of incidents rises until a trust is rated “outstanding”, at which point it drops.

These findings are in line with the CQC’s view that an open reporting culture is part of what makes a hospital better. The fall in reporting at “outstanding” trusts is in line with these trusts reporting the lowest level of staff witnessing concerning behaviour.

Care Quality Commission

Staff at ‘inadequate’ trusts worst for reporting patient harm

Source: CQC ratings and 2016 NHS Staff Survey – weighted data. Combined trust averages included as some acute non-specialist trusts are categorised as such in the Staff Survey

The CQC’s state of care in acute hospitals report, published this month, said: “In poorly led organisations, staff were not actively reporting concerns or learning from incidents.”

The analysis also shows the percentage of staff experiencing harassment, bullying or abuse and those experiencing discrimination was higher at trusts with a lower CQC rating.

There was a 9 percentage point difference between staff at inadequate and outstanding trusts experiencing bullying from colleagues in the past year.

This difference was also seen in how the public and patients treat staff, with 30% of stuff at “inadequate” trusts reporting abuse or harassment, compared to 25.6% at “outstanding” trusts, 27.8% in trusts “requiring improvement” and 26% in those rated “good”.

Care Quality Commission

Staff at ‘inadequate’ trusts worst for reporting patient harm

The CQC’s report, which was published ahead of its board meeting tomorrow, also found that 14% of staff in “inadequate” trusts reported experiencing discrimination.

This higher level was compared to 11.3% of staff at “requires improvement” trusts, 11.1% at “good” trusts and 10% at “outstanding” trusts.

For comparison purposes, the report said that nine trusts had been rated “inadequate” by the CQC, 78 rated “requires improvement”, 43 “good” and five “outstanding”.

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Readers' comments (1)

  • "Covering up" has been going on for years and years and is encouraged by all levels of Management and relates to all levels of services.
    With the introduction of CQC the top of the iceberg has been revealed, all staff should now be encouraged to report any incidents to the CQC and then on to "Safeguarding" at the County Council. Both of these bodies are independent of the NHS Trusts and therefore should be able to carry out unbiased and thorough inspections of any problems, This system is now operating effectively in Nursing Homes all over the Country and has seen dramatic results.

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