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| Are three-quarters of English hospitals really unsafe? | Are three-quarters of English hospitals really unsafe? |
| (about 1 hour later) | |
| The majority of hospitals in England are not really unsafe - of course not. That would be a staggering situation to find in the 21st century NHS. | The majority of hospitals in England are not really unsafe - of course not. That would be a staggering situation to find in the 21st century NHS. |
| But the way the Care Quality Commission has presented its evidence has allowed that idea to form. | |
| Its state of care report - essentially its annual report of what it has been up to over the last year - contains information showing 74% of the hospital trusts it has assessed since April under its new inspection regime have safety problems. | Its state of care report - essentially its annual report of what it has been up to over the last year - contains information showing 74% of the hospital trusts it has assessed since April under its new inspection regime have safety problems. |
| However, the issue with this is that the trusts in question are not really representative of the entire NHS. | However, the issue with this is that the trusts in question are not really representative of the entire NHS. |
| The figure relates to inspections of only 79 hospital trusts - that is less than half the total in existence. | The figure relates to inspections of only 79 hospital trusts - that is less than half the total in existence. |
| What is more, many of those trusts have been targeted because of existing concerns about them - the CQC has used evidence that is already available, such as death rates and staff surveys, to predominantly focus on those where there are known risks. | What is more, many of those trusts have been targeted because of existing concerns about them - the CQC has used evidence that is already available, such as death rates and staff surveys, to predominantly focus on those where there are known risks. |
| Therefore, as this inspection regime continues you would expect a rosier picture to emerge. | Therefore, as this inspection regime continues you would expect a rosier picture to emerge. |
| The other problem is how the CQC defines safe. Hospitals can find themselves falling foul of inspectors because of - some argue - relatively innocuous oversights. For example, they can be rapped over the knuckles if they fall behind on training or record keeping. | The other problem is how the CQC defines safe. Hospitals can find themselves falling foul of inspectors because of - some argue - relatively innocuous oversights. For example, they can be rapped over the knuckles if they fall behind on training or record keeping. |
| 'Strong indication' | 'Strong indication' |
| This is not to say that such issues need not be tackled. It's just that this is a very long way from what many people's definition of safe is. | This is not to say that such issues need not be tackled. It's just that this is a very long way from what many people's definition of safe is. |
| Equally, there was plenty of evidence put forward that is extremely worrying, including warnings that wards are under-staffed and patients left without being properly assessed and cared for. | Equally, there was plenty of evidence put forward that is extremely worrying, including warnings that wards are under-staffed and patients left without being properly assessed and cared for. |
| It means the CQC actually broke the 74% figure down into 13% of trusts where there was a "strong indication that care was unsafe" and 61% where safety could be improved. | It means the CQC actually broke the 74% figure down into 13% of trusts where there was a "strong indication that care was unsafe" and 61% where safety could be improved. |
| Another factor to consider is the pressure the CQC is under. It was formed in 2009 but quickly found itself facing criticism for being too soft in its inspections - at the time it was struggling to recruit inspectors and had a huge workload because it was running a new system which meant it had to register thousands of care agencies and GPs as well as hospitals. | Another factor to consider is the pressure the CQC is under. It was formed in 2009 but quickly found itself facing criticism for being too soft in its inspections - at the time it was struggling to recruit inspectors and had a huge workload because it was running a new system which meant it had to register thousands of care agencies and GPs as well as hospitals. |
| It was then hauled over the coals for its handling of Furness General Hospital - it gave the hospital that was subsequently found to have covered up the deaths of babies at its maternity unit a clean bill of health in 2010. | It was then hauled over the coals for its handling of Furness General Hospital - it gave the hospital that was subsequently found to have covered up the deaths of babies at its maternity unit a clean bill of health in 2010. |
| The CQC's chief executive and chair left in 2012 and a new leadership team was brought in. They have overseen the introduction of a new "tougher" inspection regime, which started last year and has formed the basis of this report. | The CQC's chief executive and chair left in 2012 and a new leadership team was brought in. They have overseen the introduction of a new "tougher" inspection regime, which started last year and has formed the basis of this report. |
| But a common complaint on the wards of hospitals is that inspectors are over-reacting and are too ready to damn hospitals. | But a common complaint on the wards of hospitals is that inspectors are over-reacting and are too ready to damn hospitals. |
| The result, unfortunately, is a very muddy picture in which it is extremely difficult to come to firm conclusions. | The result, unfortunately, is a very muddy picture in which it is extremely difficult to come to firm conclusions. |