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Hospitals face new army of inspectors in wake of Mid Staffordshire scandal Hospitals face new army of inspectors in wake of Mid Staffordshire scandal
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Hospitals should face tough new scrutiny of their care by beefed-up teams of inspectors including doctors and nurses, a landmark report into hundreds of unnecessary deaths at an NHS hospital will recommend next week.Hospitals should face tough new scrutiny of their care by beefed-up teams of inspectors including doctors and nurses, a landmark report into hundreds of unnecessary deaths at an NHS hospital will recommend next week.
The public inquiry into the Mid Staffordshire scandal will propose the change as part of a series of measures to overhaul the array of regulatory bodies that, despite numerous warnings, did not detect serious failings in patient care for over four years or intervene soon enough to stop them.The public inquiry into the Mid Staffordshire scandal will propose the change as part of a series of measures to overhaul the array of regulatory bodies that, despite numerous warnings, did not detect serious failings in patient care for over four years or intervene soon enough to stop them.
According to sources close to the inquiry, the long-awaited report, published next Wednesday by its chairman, Robert Francis QC, will say sweeping reforms of how hospitals are policed are needed to stop a repeat of events at Stafford hospital, where an estimated 400-1,200 patients died between 2005 and 2009 as a result of "appalling" care and neglect.According to sources close to the inquiry, the long-awaited report, published next Wednesday by its chairman, Robert Francis QC, will say sweeping reforms of how hospitals are policed are needed to stop a repeat of events at Stafford hospital, where an estimated 400-1,200 patients died between 2005 and 2009 as a result of "appalling" care and neglect.
Many patients relied on relatives to ensure they ate and drank because food and drink was left out of their reach, misdiagnosis of medical problems was common, pain-relieving drugs were not given or given late, and hygiene was so poor that relatives had to clean toilets themselves to avoid catching infections. "Many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives," said Francis in his first report into the hospital in 2010.Many patients relied on relatives to ensure they ate and drank because food and drink was left out of their reach, misdiagnosis of medical problems was common, pain-relieving drugs were not given or given late, and hygiene was so poor that relatives had to clean toilets themselves to avoid catching infections. "Many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives," said Francis in his first report into the hospital in 2010.
Francis is understood to call for hospitals to undergo more regular, and much more far-reaching, inspections to ensure standards are being met through improved surveillance. He will also highlight the need to tackle a shortage of experts with clinical experience, such as doctors and nurses, among the 955 inspectors used by the Care Quality Commission (CQC) to visit NHS hospitals. Many have backgrounds in social care, such as care homes and social work, rather than NHS care.Francis is understood to call for hospitals to undergo more regular, and much more far-reaching, inspections to ensure standards are being met through improved surveillance. He will also highlight the need to tackle a shortage of experts with clinical experience, such as doctors and nurses, among the 955 inspectors used by the Care Quality Commission (CQC) to visit NHS hospitals. Many have backgrounds in social care, such as care homes and social work, rather than NHS care.
Francis will also pin much of the blame for why poor care persisted so long at Stafford on NHS managers and regulators. "The criticism Francis will make of the NHS will involve him saying that in effect there was a self-protecting elite that refused to countenance complaints from patients and their relatives which compounded the agony that they felt. He will be excoriating about NHS managers," said a source familiar with his thinking.Francis will also pin much of the blame for why poor care persisted so long at Stafford on NHS managers and regulators. "The criticism Francis will make of the NHS will involve him saying that in effect there was a self-protecting elite that refused to countenance complaints from patients and their relatives which compounded the agony that they felt. He will be excoriating about NHS managers," said a source familiar with his thinking.
Francis's first report revealed how the hospital trust cut staff, especially nurses, and neglected quality of care as it sought to balance its books in its determination to become a foundation trust.Francis's first report revealed how the hospital trust cut staff, especially nurses, and neglected quality of care as it sought to balance its books in its determination to become a foundation trust.
In future, Monitor, which regulates NHS trusts, will be expected to share concerns about financial problems so the CQC can check if that is also affecting the care it provides.In future, Monitor, which regulates NHS trusts, will be expected to share concerns about financial problems so the CQC can check if that is also affecting the care it provides.
Francis will also recommend that the CQC boosts its collection and use of intelligence about hospital care – drawing together patient complaints, media reports and the results of clinical audits – so that action can be taken as soon as such information suggests that a problem has emerged.Francis will also recommend that the CQC boosts its collection and use of intelligence about hospital care – drawing together patient complaints, media reports and the results of clinical audits – so that action can be taken as soon as such information suggests that a problem has emerged.
Francis, whose inquiry took two and a half years and cost £13m, wants the CQC to co-ordinate a drive with several other key NHS bodies to share all forms of information about how a hospital is performing, clinically and financially, as the two are often closely related. That would also include patient feedback and data from the new local quality surveillance groups that the commissioning board plans to create across England.Francis, whose inquiry took two and a half years and cost £13m, wants the CQC to co-ordinate a drive with several other key NHS bodies to share all forms of information about how a hospital is performing, clinically and financially, as the two are often closely related. That would also include patient feedback and data from the new local quality surveillance groups that the commissioning board plans to create across England.
But sources say Francis is "unlikely" to back two changes which campaigners say are vital to protect patient safety: legal minimum staffing levels, which the Royal College of Nursing supports, and for every NHS employee to have a legal "duty of candour" to disclose to patients any mistakes they make, which is being sought by lobby group Action against Medical Accidents and has been supported by Liberal Democrat health minister Norman Lamb. But sources say it is uncertain if Francis will back two changes which campaigners say are vital to protect patient safety: legal minimum staffing levels, which the Royal College of Nursing supports, and for every NHS employee to have a legal "duty of candour" to disclose to patients any mistakes they make, which is being sought by lobby group Action against Medical Accidents and has been supported by Liberal Democrat health minister Norman Lamb.
Some of Francis's recommendations could give the government a dilemma over whether to agree to act on them all. Ministers have recently instigated several changes to the monitoring of hospitals, such as introducing a 'friends and family' test and exploring a system of Ofsted-style ratings, which they may cite as evidence that they have already addressed many of Francis's key concerns. The health secretary, Jeremy Hunt, will not guarantee to implement all the recommendations despite his predecessor, Andrew Lansley, appointing Francis.Some of Francis's recommendations could give the government a dilemma over whether to agree to act on them all. Ministers have recently instigated several changes to the monitoring of hospitals, such as introducing a 'friends and family' test and exploring a system of Ofsted-style ratings, which they may cite as evidence that they have already addressed many of Francis's key concerns. The health secretary, Jeremy Hunt, will not guarantee to implement all the recommendations despite his predecessor, Andrew Lansley, appointing Francis.