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Preparing nurses for a Healthcare Commission assessment

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The Healthcare Commission has informed your trust it will visit in the next three months to carry out an annual performance assessment. A ward sister discovers that her ward is likely to be subject to the visit. What action, if any, should she take?

Many inspection bodies have rights to visit hospitals, including the Health and Safety Executive, the Clinical Negligence Scheme for Trusts and the Healthcare Commission.

The commission makes an annual assessment of the performance of NHS organisations in England. It looks at two key areas – quality of services (including patient safety, cleanliness and waiting times) and the use of resources (financial management). It rates them on a scale from weak to excellent.

Trusts are asked to assess their performance and the extent to which they meet core standards. A fifth are inspected annually. Self-assessments are compared with data obtained by the commission, and that from about 30 other sources such as patient and public involvement forums.

In some circumstances the Healthcare Commission may decide an investigation into a trust’s performance is necessary. It has completed 15 investigations since it was established in 2004 – the reports are available on its website. Two investigations are ongoing.

The Commission also inspects 170 trusts a year on healthcare-associated infections. Inspections for cross-infection control are unannounced ‘to ensure that the assessors see the hospital as a patient or visitor would see it. Each inspection gives a “snapshot” of how well a trust is working to reduce the risk of patients getting a HCAI’.

Although the commission warns each trust selected for the HCAI inspection that it will be inspected in the following three-month period, the inspection itself is unannounced. It will last for at least a day. Compliance with hygiene code duties is assessed, systems for infection control are examined and there will be a physical check to ascertain that these are implemented. Be aware that things such as dirty commodes on a ward may indicate a risk to patients and that one of the trust’s systems for control is failing.

The best advice to the ward manager is for her to ensure infection control standards are met at all times, not just when an inspection is due. She could then be indifferent to the timing of the visit. However, she will only achieve this level of performance if she is familiar with the standards, has the resources to ensure they are implemented, has constant supervision for monitoring in place, and takes up and
resolves concerns about meeting the standards with senior managers.

These rules would also apply to patient safety and the use of resources.

From 1 April 2009 the work of the Healthcare Commission, the Mental Health Act Commission and the Commission for Social Care Inspection will be taken over by the Care Quality Commission.

Bridgit Dimond, MA, LLB, DSA, AHSA, is barrister-at-law and emeritus professor, University of Glamorgan, Pontypridd

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Readers' comments (1)

  • The trust may be told they will be visited within 3 month but believe you me we find out well before they arrive hence the arrival of majority of our contract cleaners and everybody else preparing the trust for the HCC coming.

    Maybe they should make it into "the secret patient or visitor" (where they come in through A&E as a patient right to the ward)- then they will get their eyes opened or make visits unannounced.

    I believe government are scared of what they will actually find!

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