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The Care Quality Commission

30th November -0001

Croydon hospital midwife shortage

30th November -0001

The Care Quality Commission has ordered Croydon University Hospital to address shortages of midwives in its maternity unit.

It found the number of midwives was insufficient to ensure patient safety or that their needs were met when it visited the hospital, which is run by Croydon Health Services Trust, in February. Other issues included equipment not always being available when required and evidence that staff training was not up to date. The commission acknowledged that the trust was in the process of recruiting additional midwives at the time of its review.

 

Nearly-all-clear for foundation trust

27th September 2010

The CQC has lifted two conditions on the licence of Basildon and Thurrock University Hospitals Foundation Trust after an unannounced inspection.

Appointment of CQC chair endorsed

16th September 2010

Dame Jo Williams faced some tough questioning at a pre-appointment.

Internal staff survey results leaked

8th July 2010

Results of a leaked internal staff survey have shown that only 16% of the Care Quality Commission’s employees think it is well managed.

The survey, filled in by 1,473 staff in May - a 76% response rate - reveals employees highly rate their line managers and teams. The majority said they felt able to ask members of their team for help or advice when needed and agreed their team co-operated to get work done. But only 14% said they had confidence in decisions made by the executive team.

 

Nursing failure uncovered by CQC

16th June 2010

A Care Quality Commission review has uncovered poor staff supervision and nursing failures.

Tough targets for suspended Clinicenta

7th May 2010

A private provider which was suspended amid concerns over patient safety has been set tough new quality targets.

NHS managers are drawing up an ‘assurance framework’ to satisfy the Care Quality Commission that Clinicenta, whose contract with 20 London PCTs has now entered a sixth month of suspension, is fit to start treating their patients again. Its contract in the capital was suspended in November after NHS London launched an investigation into the death of a patient and the CQC claimed it may have put patients at risk.

 

Death rates poor measure of hospital performance

21st April 2010

Two experts writing in the British Medical Journal have said hospital death rates are a "poor test of quality" and should not be used to measure performance.

Their stance opposes those who feel the Care Quality Commission should pay closer attention to the privately produced Dr Foster death rates.

The two experts, Professor Richard Lilford, from Birmingham University, and Peter Pronovost, from Johns Hopkins University in the US, were critical of how mortality data was employed to criticise Stafford Hospital recently.

The trust has faced heavy fire from patients, the government and the NHS regulator for its "appalling care" which was reported to have potentially caused 400 deaths.

However the experts said the assertions were "precarious" and the use of death rates to measure performance was only being "kept alive by well-meaning decision-makers".

Death rates compiled by companies such as Dr Foster make a calculation about whether death rates at a trust are higher than average after patients' ages and the gravity of their condition was measured.

The health service, particularly the CQC, uses the information as a way to monitor how safe patients are at each trust.

The rates do not contribute to how a hospital is rated in performance data. The CQC can employ the figures as a way of cross-checking a hospital's assertions about its performance. 

A CQC spokeswoman said: "We do not use mortality rates to assess quality of care directly, but we do use them to direct where we need to dig deeper, for example by conducting an inspection or requesting further information."

 

CQC forced to issue warning notices

15th April 2010

The Health Service Journal has reported that powers given to the Care Quality Commission have been watered down.

The move has seen a weakening of the regulator’s powers to prosecute trusts failing to meet registration standards in an effort to head off legal challenges and bad publicity.

HSJ says it has seen e-mailed documents on the subject which reveal powers allowing the CQC to treat failures as criminal offences were called “unusual and unexpected” by the Commons joint committee for statutory instruments.

The CQC is understood to have opposed the move because that would make it more difficult for it to bring about prosecutions with a requirement to force it to issue draft registration decisions which could leave it vulnerable to challenges from providers.

The Department of Health has added an amendment to the CQC’s powers, forcing it to issue warning notices before bringing prosecutions with trusts having a right to appeal registration.

It has also emerged that CQC chief executive Cynthia Bower was pressured into announcing registration decisions in batches, rather than in one go on 1 April.

That followed health secretary Andy Burnham’s pledge to bring the registration process forward in response to the Mid Staffordshire Foundation Trust scandal.

However, the CQC told HSJ it made the announcements on registration in batches due to the high volume of data involved in the process and because of the need to inform a wide range of stakeholders.

All 378 NHS trusts in England have now been registered but 22 had conditions imposed on them.

 

Top hospitals told to improve

1st April 2010

A patients group has raised questions over the elite status of foundation trusts after 12 were among a group told by the Care Quality Commission to improve or face tough sanctions.

The Patients Association said it showed that too much emphasis was being placed on financial performance rather than quality of care.

All 378 trusts in England need a licence from the CQC to work in the NHS under a new regime from 1 April.

The regulator attached conditions to 22 - 12 of which were foundation trusts - meaning they could face fines or suspension if they do not act.

Katherine Murphy, director of the Patients Association, said: "Foundation trusts are meant to be the premier league of the NHS. But these results call into question the assessment process and actual status.

"We believe there is too much emphasis placed on financial performance rather than quality of care. The foundation trust regime needs looking into."

Under CQC registration trusts are assessed against 16 standards and having conditions attached means they will face regular assessments and run the risk of fines, prosecution or services being suspended. They also have to show they are financially viable and can provide good services.

Since 2004, almost 130 trusts have been given foundation status but confidence in the process has already been questioned because of scandals at the Mid Staffordshire and Basildon and Thurrock trusts, both of which have foundation status.

Monitor, which is in charge of the foundation trust process, said the results were disappointing.

 

CQC highlights problems at 10 more trusts

26th March 2010

A second wave of registration decisions by the Care Quality Commission has highlighted problems at 10 trusts.

While a further 214 trusts have been registered, for 10 organisations this is conditional on them making urgent improvements. Trusts registered with conditions are: Devon Partnership Trust, Kent and Medway NHS and Social Care Partnership Trust, Luton and Dunstable Hospital Foundation Trust, Mid Essex Hospital Services Trust, Northern Lincolnshire and Goole Hospitals Foundation Trust, Scarborough and North East Yorkshire Healthcare Trust, Surrey and Borders Partnership Foundation Trust, Surrey and Sussex Healthcare Trust, West London Mental Health Trust and Yorkshire Ambulance Service Trust.

 

Maternity services need to improve

19th January 2010

The Care Quality Commission has called for a hospital where two babies died to hire more permanent midwives and provide more beds in maternity wards.

A report by the CQC said that Milton Keynes Hospital NHS Foundation Trust had made improvements to maternity care since 2008. However, it said that more changes were needed to raise the standard of maternity care.

The hospital was the subject of inquests in 2007 and 2009 after the deaths of two babies.

The CQC said the hospital needed to make faster changes to its maternity care in order to provide "safe and effective care for mothers and babies".

It added that provisional improvements set up by the hospital were "not sustainable" and said the trust should concentrate on making permanent changes.

Dr Sandro Lanzon-Miller, medical director at Milton Keynes Hospital, said: "We took action immediately following the visit made by the Healthcare Commission."

"We put temporary measures in place to ensure that we always have enough midwives to deliver safe and effective care to local mothers, while we work to recruit more permanent midwives. We are steadily appointing additional midwives to our team and our recruitment drive continues."

CQC head steps down

7th December 2009

Baroness Barbara Young is to step down from her post as head of England's independent health and social care regulator, the Care Quality Commission, from February.

She told ministers of her decision to leave the role towards the end of November saying she had pointed the CQC “in the right direction” but now wanted to see others take it forward. Dame Jo Williams, former chief executive of the mental health charity Mencap, will take charge of the CQC until a permanent successor is found.

 

Owner of beautician chain prosecuted

19th November 2009

The CQC has prosecuted the owner of Waveriver Limited for operating hair removal lasers without registration.

Discharge summaries criticised

28th October 2009

Healthcare regulator the Care Quality Commission has raised concerns over patient care when it is share between hospitals and GPs.

It said poor communication about medications was the major issue after surveying 280 GP practices from 12 primary care trusts.

While the CQC noted examples of good practice, there were areas that needed improving.

The main concerns were: that GP practices and hospitals not always sharing complete patient information on medication changes when people moved between services; reviewing and updating of GP records was sometimes left to administrative staff; GPs did not routinely review new medication with a patient after they left hospital; and learning and monitoring from serious incidences was inconsistent.

CQC Chief Executive Cynthia Bower said evidence of good management of medicines when care is shared, would be a requirement of registration with the Commission by 2012.

She said: "There needs to be a change of attitude in the NHS in recognising how important it is for clinicians to pass the baton smoothly between services in order to offer person-centred, integrated care."

With only 55% of GPs saying patients were present during medication reviews "most of the time", 36% "some of the time" and 5% "hardly ever”, the CQC has recommended GPs should increase the number of patients who are present for their medication reviews.

RCGP Chairman Professor Steve Field said: "Patients can feel especially vulnerable when they are discharged from hospital and they need to be safe in the knowledge that their GP is working with the most comprehensive and accurate information available."

 

NHS news 16/10/09

16th October 2009

A round up of NHS news over the past week.

Watchdog to get tough on NHS

15th October 2009

The Care Quality Commission has told as many as one in eight NHS trusts that they must urgently improve the care they provide.

The warning comes as ratings on England's 392 trusts have been published and ahead of new powers the CQC will receive from next April to close down any of the 47 underachieving trusts down.

Despite the failures, there are a number of areas that the regulator point to as successes, including the notable achievement of most patients in England receiving hospital treatment within 18 weeks.

The CQC also noted that 98% of the 19 million patients who attended A&E waited less than four hours.

NHS Ratings Health Minister Mike O'Brien said the report showed improving standards across the health service.

"We have transformed the waiting experience for millions of patients and now have the shortest waits on record. MRSA and C difficile infections have been significantly reduced and over three quarters of GP surgeries are providing extended opening hours, giving patients greater choice and more convenient access to GPs," he said.

More than half of primary care trusts were rated good or excellent, with many patients reporting being able to get an appointment within two days.

But there were regional variations and trusts in London showed particularly poor performances on patient satisfaction with appointments and opening times.

Also, fewer mental health trusts were rated excellent or good and ambulance services also failed to perform as well as last year, though the CQC praised the general response to emergency calls.

 

CQC confronted by mental health chiefs over survey

8th October 2009

Chief executives from mental health trusts are to meet the Care Quality Commission to discuss its handling of results from the national inpatients survey.

They are expected to tell the regulator in a “robust and challenging conversation” that they think findings from the biggest ever national mental health inpatients survey, published two weeks ago, were distorted to present an unfairly negative picture. Mental Health Network director Steve Shrubb said that he had received dozens of emails from members about the survey.

 

CQC focusing on value for money

28th August 2009

The Care Quality Commission is set to step up its focus on NHS finances.

The health care regulator wants to ensure that commissioners get value for money ahead of an expected public spending squeeze and will be examining financial data to scrutinise variations in primary care trusts’ spending and check they are investing in good quality services.

The aim is also to make assessments of PCTs and councils more closely aligned with joint annual commissioning reviews a possibility by 2011/12.

 

Basic care lacking in hospitals

27th August 2009

A patient lobby group has highlighted accounts of what it calls appalling NHS standards.

In the light of the reports from relatives of patients, the Patients Association wants an urgent review of basic hospital care.

The group’s report focused on 16 cases in England with elderly people left lying in urine and not being helped to eat, but says it is an example of hundreds of similar cases.

The Association is concerned that a self assessment approach means health authorities are ignoring problems raised and it has now called on the Care Quality Commission to intervene.

Earlier this year, grave lapses in care were highlighted at the Mid Staffordshire NHS Trust.

Patients Association director Katherine Murphy said: “Whilst Mid Staffordshire may have been an anomaly in terms of scale the Patients Association knew the kinds of appalling treatment given there could be found across the NHS.”

Group president Claire Rayner said: "I am sickened by what has happened to some part of my profession of which I was so proud. These bad, cruel nurses may be - probably are - a tiny proportion of the nursing work force, but even if they are only 1 or 2% of the whole they should be identified and struck off the Register."

Government chief nursing officer Chris Beasley acknowledged the poor care received in the cases highlighted was unacceptable.

While not condoning the behaviour of the nurses Royal College of Nursing chief executive Peter Carter stressed the report was based on 2% of patients who felt their care was unacceptable.

 

CQC plans to suspend NHS inspections

30th July 2009

The Care Quality Commission plans to suspend hygiene inspections if the flu pandemic worsens.

Broadmoor 'failings' concern

21st July 2009

A Care Quality Commission (CQC) report has criticised the West London Mental Health NHS Trust for its failure to keep patients safe at Broadmoor Hospital.

The report pointed out that patients had hanged themselves from window bars while being treated at the high-security hospital.

The trust responded by saying the bars were a part of the building and as it was a listed site they could not be taken off.

The trust supplies healthcare at the hospital in Crowthorne, Berkshire, in addition to other services in west London.

Broadmoor is responsible for 260 patients, including the Yorkshire Ripper. Eight patients have killed themselves in eight years - many more than at England's other high-security hospitals.

The CQC said the trust's board had not strongly tackled "serious concerns" including lack of beds, building issues, few staff and insufficient staff training.

Barbara Young, CQC's chairman, said: "Given the nature of its services, the organisation should be leading the way in managing risks, yet in some instances they tolerated poor and mediocre practices."

She added: "The same problems about managing risk, overcrowding, sub-standard buildings and staff shortages were raised on a number of occasions, yet the trust's response was slow and piecemeal."

"The trust was good at writing policies, but not good at putting them into action."

CQC looking for feedback

2nd June 2009

The Care Quality Commission has launched a consultation on registration standards.

Hospital stays should be improved

14th May 2009

The Care Quality Commission says the NHS still has a long way to go to ensure hospital stays are as good as they should be.

In a poll of 72,000 people, some 93% of patients in England rated care as good, very good or excellent overall.

However, many patients remain frustrated by the standards of other aspects of care such as food, noise and delays.

As many as one in five did not get help with meals, 14% rated the food as poor and a third of patients were bothered by noise at night.

The NHS was still not good on answering call buttons with 15% waiting longer than five minutes and 2% getting no answer.

Delays in discharge continued, often through waits for medication, while mixed sex accommodation remained an issue.

Almost 10% of patients felt they had wanted to make a complaint about their care.

CQC chief executive Cynthia Bower said: "Patients are clearly highlighting some persistent problems.

"It is a great shame that the NHS has not managed to get a stronger grip on these issues when patients have been highlighting them for so long."

Patients did feel that there were improvements in infection prevention with 95% of rooms clean, and doctors and nurses washing their hands.

Health Minister Ann Keen said the high overall rating was a testament to the hard work and dedication of staff but said the NHS would continue to focus on areas highlighted where there was still more work to be done.

 

Mental health services 'closed to elderly'

31st March 2009

The Healthcare Commission has said that mental health care is not as easily available to people aged over 65 as it is to younger patients.

The Commission discovered that in four of the six mental health trusts they looked at, a decision about mental healthcare was "based as much on age as clinical need".

The Commission's chief executive Anna Walker said the situation was "unacceptable".

The researchers said that elderly people could not access healthcare due to overstretched services. As a result, they were often unable to use alcohol support services and psychological therapies.

Ms Walker said: "It is truly unacceptable that out of hours and crisis services were often not available to older people. There needs to be a fundamental shift towards providing care based on a person's clinical need rather than their age."

She added that in light of the fact that 25% of admissions for mental health inpatient care were for over 65s, the topic required "urgent attention".

Care Services Minister Phil Hope said they expected NHS trusts to improve the situation.

Another study carried out by the Commission of the 68 NHS specialist community mental health trusts in England discovered that nearly 50% of  patients aged under 65 could not call an out-of-hours number if they had a problem.

 

Call for better early warning systems

23rd March 2009

The Healthcare Commission has said that early warning systems on patient safety incidents must be improved.

Trust criticised for high death rate

17th March 2009

The Healthcare Commission has criticised the low standards of care at a hospital which caused needless deaths.

The watchdog said that between 2005-2008 there were 400 more deaths at Staffordshire General Hospital "than would be expected".

It stated that it found "virtually every stage" of emergency care to be deficient and that health bosses tried to attain targets at the expense of patient care.

Health Secretary Alan Johnson has issued an apology and started an inquiry.

Mr Johnson said they would investigate Mid Staffordshire NHS Foundation Trust between 2002-2007 alongside an independent review into emergency services.

Mr Johnson said: "There was a complete failure of management to address serious problems and monitor performance. This led to a totally unacceptable failure to treat emergency patients safely and with dignity."

The commission began investigating the hospital in 2008 following reports from local people which corresponded with a high number of deaths.

The commission's report said a low number of staff, "inadequate nursing", not enough equipment or leadership were among the problems apparent at the hospital.

The trust's chairman Toni Brisby and chief executive Martin Yeates handed in their resignations earlier in March.

The commission's chairman Sir Ian Kennedy said: "This is a story of appalling standards of care and chaotic systems for looking after patients."

"There is no doubt that patients will have suffered and some of them will have died as a result."

 

Child hospital care warning

13th March 2009

The Healthcare Commission has warned that the NHS needs to improve the care it offers children.

The watchdog said health service staff needed to receive better training on how to spot signs of child abuse after discovering that less than a third of the 154 hospital trusts in England failed to meet child protection training standards.

It also warned 63% of NHS hospital trusts did not do enough to ensure surgeons maintained the skills needed to operate on children.

The latest analysis follows up a survey conducted two years ago which found a fifth of trusts were unable to provide round-the-clock emergency care for children.

While the Commission said there had been improvements, there was still some way to go.

It wants staff to receive child protection training annually, rather than three-yearly and surgeons and anaesthetists to perform more surgery to maintain their skills.

Three-quarters of trusts failed to meet requirements that anaesthetists should perform 20 procedures per year, while surgeons should perform 100.

Commission chief executive Anna Walker said: "There have been improvements but more work is clearly needed. We are particularly concerned about training in child protection.

"It is absolutely vital that NHS staff working with children know how to recognise signs of child abuse and know what to do if they see it.

"Another area of concern is that some surgeons and anaesthetists appear to be performing procedures on children without meeting the recommended levels of work to maintain their skills."

The Royal College of Paediatrics and Child Health expressed concern at the findings.

 

Homerton infection control practices

5th March 2009

The Healthcare Commission has announced that Homerton University Hospital NHS Foundation Trust has made necessary improvements in infection control.

The trust is now compliant with the requirements of an improvement notice issued in December which required immediate changes to infection control practices following a two day unannounced visit last November. The trust has been assessed on how it was following the hygiene code and serious breaches relating to the decontamination of equipment, inadequate mandatory staff training and a lack of follow up to internal audits.

 

Mid Staffordshire foundation trust's chief resigns

4th March 2009

The chairman and chief executive of Mid Staffordshire foundation trust have resigned ahead of the publication of a Healthcare Commission report.

Regulator Monitor has already stepped in to appoint replacements following the departure of chair Toni Brisby and chief executive Martin Yeates. The Commission’s report is believed to highlight inadequacies in aspects of the quality of clinical and nursing care at the trust along with "broader governance and senior management failings". The report was prompted by high mortality rates, particularly in emergency admissions.

 

NHS told to do better with complaints

16th February 2009

The Healthcare Commission has said that the health service needs to improve how it handles complaints.

Current procedure means complaints in England are handled by health service trusts. However, complaints can be directed up the chain to the Healthcare Commission and finally to the Ombudsman.

The Commission has published a report which showed the amount of complaints upheld by the watchdog increased by 50% in 2008 in comparison to the previous year.

The report has been released before changes are introduced later in 2009 which will allow patients to take their case directly to the Ombudsman if they do not agree with how the trust has handled their complaint.

Around 135,000 complaints are submitted to the NHS every year. Of this figure, about 9,000 are unable to be dealt with locally and are passed on to the Commission.

30% of these complaints were upheld by the Commission - an increase of 20% from 2007.

The Commission gave back 17% of complaints to the trusts who originally passed them upwards because "their approach to tackling them was deemed insufficient".

Healthcare Commission chief executive Anna Walker said: "It is very important that people feel that they can complain about their NHS trust if they need to and that the trust will respond positively to their complaint and learn general lessons from it."

 

East Yorkshire warned to improve safety of patients

13th February 2009

The Healthcare Commission has warned a Yorkshire-based independent mental health hospital that it expects significant improvements in the safety and quality of services.

The Commission has published two inspection reports on Linden House, a 97-bed medium- and low-secure hospital, owned by Care Principles Ltd and situated in Market Weighton, East Yorkshire. The notices make clear requirements for action and the Commission says it will carry out further spot checks to assess progress, stressing that it will take stronger enforcement action if necessary.

 

NHS should improve healthcare in prison

12th February 2009

The NHS has been urged to provide better healthcare for adults in the prison system.

The call comes jointly from the Healthcare Commission and Her Majesty's Inspectorate of Prisons (HMIP), which have published a joint report on the commissioning of healthcare services in prisons.

Both organisations said that commissioning of healthcare services by primary care trusts (PCTs) was variable and did not always meet the health needs of individual prisoners.

They pointed to a lack of planning and poor assessment of the health needs of prisoners and few PCTs commissioning court diversion schemes, which may help to divert offenders with mental health problems out of the criminal justice system and into appropriate health services.

Anna Walker, Healthcare Commission Chief Executive, said: "We know that prisoners generally have poorer health than the general population. Statistics show that 90% have a mental health problem, a problem with drugs and alcohol, or both.

"It is clear from our work that, while improvements have been made, healthcare for offenders is not what it should be - for adults and young people. This must change, not just because it is the right thing to do for individuals, but because it is the right thing to do if we are serious about addressing the causes of crime."

Dame Anne Owers, Chief Inspector of Prisons, said: "This report shows the value of the joint approach to inspection of prison healthcare.  Together, we can identify improvements and gaps, and ensure that recommendations for improvement are effectively followed up, either with the PCT or the prison."

 

Better maternity services at Newham University Hospitals NHS Trust

22nd January 2009

The Healthcare Commission has said that Newham University NHS Trust had made substantial improvements to its maternity services.

The watchdog said the trust had provided more beds, more staff and better management of risk in a report that outlined progress following a formal review of the Newham service in 2007. The investigation came after almost 800 women were not booked for antenatal care appointments in late 2006 and early 2007, despite being referred for this service. There were six key recommendations made from an initial visit by the Commission.

 

London trust told to improve cleanliness

16th January 2009

The Healthcare Commission has called on South West London and St George’s Mental Health Trust to improve cleanliness and provide more activities for patients.

Findings from the watchdog’s independent assessment of three wards within the trust have been published and make recommendations to improve the care of patients. The move follows an assessment started in July 2008, after the Healthcare Commission was alerted to concerns about cleanliness and a lack of engagement between staff and patients. Inspections were made of the John Meyer Ward at Springfield University Hospital and the Laurel and Lavender Wards at Queen Mary’s Hospital.

 

A&E care praised by patients

14th January 2009

A healthcare watchdog has revealed that patients highly rate the care they receive in NHS A&E departments.

But the Healthcare Commission also found that there were concerns about pain control and information given to patients on discharge.

Overall, patients were positive about A&E with 88% rating it as "excellent", "very good" or "good", according to a survey from the organisation.

It also found that 69% of patients who travelled to A&E in an ambulance rated the care they received from the ambulance staff as "excellent".

Information was gathered from almost 50,000 patients aged 16 or over who had visited an A&E or emergency department at 151 hospital trusts between January and March 2008.

Since the study was last conducted in 2003 and 2004, a picture of improved communication had emerged with more patients feeling they had time to discuss their condition and were being listened to.

However, the survey did highlight areas of concern, notably over pain control while many patients said they did not get enough information when they left an A&E department.

While 98% of patients waited less than four hours to be examined by a doctor or nurse, 27% said their overall visit to the emergency department lasted longer than four hours.

Commission chief executive Anna Walker said: "It is good to see that so many patients are so positive about their care by ambulance staff and in A&E and that there have been improvements in communication. These achievements come against a backdrop of significant rises in demand for A&E services."

 

Hospital broke hygiene rules

31st December 2008

Homerton University Hospitals NHS Foundation Trust in east London has been ordered to make urgent improvements after it breached hygiene rules.

The Healthcare Commission has served the hospital with an improvement notice over infection control after inspectors found dirty bedpans and commodes in the hospital and criticised its decontamination of surgical equipment and its staff training. The breaches of the hygiene regulations were discovered during an unannounced visit in November. The trust has since appointed a team to address the issues raised.

 

MRSA rates in NHS continue to decline

18th December 2008

New figures show significant falls in the number of MRSA cases in hospitals.

Cases fell by 13% in the last three months and are down 33% compared with the same period last year.

Data from the Health Protection Agency (HPA) reveal that in the period July to September there were 725 cases compared with 837 in the preceding three months.

Director of the HPA's centre for infections Professor Mike Catchpole said: "This continued reduction in cases of MRSA is testament to the huge efforts being made across the NHS to tackle the problem of healthcare-associated infections, which remain a big challenge throughout the world.

"To ensure this downward trend continues, we cannot be complacent. We must all play our part - the public and healthcare workers - by ensuring the infection control measures that have made the current fight against MRSA so successful remain in place."

The Healthcare Commission applauded the progress on MRSA rates but is continuing to inspect every hospital trust to check they are taking the necessary measures against all healthcare-associated infections.

The independent watchdog is to extend inspection to primary care trusts, mental health trusts and ambulance trusts.

Chief executive Anna Walker said: "This is big news for patients and a huge credit to all NHS staff. The sustained reductions show that the NHS is coming to grips with MRSA - it must not lose the momentum.

"We are clear NHS trusts are taking infection prevention and control very seriously. This has played a key role in the decline in MRSA rates."

 

Birmingham Children's Hospital investigated

11th November 2008

The Healthcare Commission has announced that it plans to launch an investigation into "serious concerns about care and management" at Birmingham Children's Hospital foundation trust.

Issues at the trust have been raised including substandard management and a "lack of confidence in managers at all levels". These included not reporting incidents and staff issues.

Health Secretary Alan Johnson has asked the Commission to investigate the problems.

Services at the trust included in the review are renal transplant, liver transplant, neurosciences and vascular services.

Heart of Birmingham teaching PCT told the trust it must perform a review to address the issues.

A report for Heart of Birmingham, South Birmingham and Birmingham East and North PCTs said: "The lack of clinical incident reporting is an area of serious concern with regard to good governance."

Heart of Birmingham chief executive Sandy Bradbrook said this was "a good example" of how a commissioning organisation could affect and "ensure patient safety and improvement of quality services".

The hospital said through a spokesman that there was "absolutely no clinical risk to patients".

The spokesman added that the hospital was not hiding anything and they had asked Great Ormond Street Hospital to look into the issues and publish a public report of their review.

The Healthcare Commission will publish a report following its investigation.

 

Services to improve at Sussex orthopaedic centre

30th October 2008

A health watchdog has found that Sussex Orthopaedic NHS Treatment Centre has taken action to improve the safety of patients.

Inspections earlier this year by the Healthcare Commission identified serious concerns.

From an inspection in February, concerns were about poor processes for the prevention of serious incidents, gaps in staff training, management practices and hygiene procedures.

From a further inspection in June, the Commission found progress in the management of serious incidents and staff training but its assessment of the operating theatre showed lapses in decontamination practices and operating theatre procedures.

However, the Commission has now ruled the treatment centre has made significant improvements and it is satisfied that its concerns have been addressed.

Sussex Orthopaedic NHS Treatment Centre is an independent sector treatment run by Care UK providing orthopaedic surgery, such as hip and knee replacements, to NHS patients on the site of the Princess Royal NHS Hospital at Haywards Heath.

The Commission made 15 recommendations to the provider following the June inspection detailing the actions needed to remedy the areas of non-compliance across decontamination practices, management of theatre equipment and record keeping.

Nigel Ellis, the Commission's Head of Investigations, said: "We are satisfied that Sussex Orthopaedic NHS Treatment Centre has now made vital improvements to its service, and that the safety of patients is not compromised.”

He added: “They must now continue to drive improvement in staff training and management of serious incidents and we will maintain close contact with the centre, keeping up the pressure to make sure this happens."

 

Hospital trust breaking hygiene rules

28th October 2008

A health watchdog has found the largest hospital trust in the country has breached hygiene rules.

Improvements for heart patients at Oxford Radcliffe

24th October 2008

According to a report by the Healthcare Commission, Oxford Radcliffe Hospitals NHS Trust has significantly improved the care of cardiac surgery patients.

Mary Cridge, Interim Head of the Healthcare Commission in the South West said: "It is clear that the trust has put considerable effort into developing a new model of care for looking after the many high risk patients who come to Oxford. The staff have worked together to address the changes which we called for last year."

 

Annual health check scores, trusts too optimistic

23rd October 2008

Over two thirds of NHS trusts were given lower scores for standards by inspectors than the ones they marked themselves, says the Healthcare Commision.

The Commission visited the trusts as part of the annual health check. Some of the trusts are disputing the marks they have been given. A commission spokesperson said: "When people do poorly in an assessment, they sometimes seek to take issue with the test. But patients want trusts to concentrate on the issues the results raise. We would therefore urge trusts to respond to what the assessment shows."


 

View the webcast of annual health check 2007/08

15th October 2008

http://www.livegroup.co.uk/ahcpressconference2008/

 

Ashford and St Peter's improves infection control practices

13th October 2008

Health watchdog the Healthcare Commission has confirmed that Ashford and St Peter's Hospitals NHS Trust has made necessary improvements in infection control.

Following an unannounced visit, the Commission found serious breaches of parts of the hygiene code which covered the arrangements for clean and appropriate premises and decontamination of surgical equipment. However, it has now said the trust is compliant with the requirements of an improvement notice which required immediate changes to infection control practices.

 

NHS performance ratings to be revealed

13th October 2008

Performance ratings will be published on by the Healthcare Commission for each NHS trust in England.

The Commission's annual health check, the third to date, will review information from all the 391 trusts. Gary Needle, Head of Assessment and Methods at the Commission, said: "We all have ownership of the NHS, so it’s only right that patients and the public should be able to see detailed information about how their local services are performing and whether they are meeting core standards."

 

NHS staff survey launched

10th October 2008

The annual health service staff survey has been sent out by the Healthcare Commission to prompt staff to give their experience of working within the NHS.

The survey is carried out every year and is the sixth to date. Over 250,000 NHS staff will be invited to give their feedback. The date is then used by the Healthcare Commission, the DoH and NHS trusts to modify services and provide improved care.

Review of heart transplant services at Harefield hospital

9th October 2008

The Healthcare Commission is working jointly with the National Specialised Commissioning team.

Emergency NHS care concerns

26th September 2008

The Healthcare Commission has raised concerns about the state of emergency care services in England.

It focussed on A&E departments, out-of-hours GP services, NHS Direct, walk-in centres and ambulance care and found that in 40% of areas the standard was not good enough.

In a report, the Healthcare Commission found that patients faced delays or were confused over where to go for the help they needed.

Overall, parts of the urgent and emergency care service suffered communication problems in different parts of the NHS. Only a third of the 152 primary care trusts, which are responsible for coordinating local services, had active networks in place.

The Commission found fewer than half of GP services had arrangements in place to divert callers to the out-of-hours provider, while a third of out of hours providers failed to respond to calls quickly enough.

It was also found that ambulances have been unable to get back into service quickly enough after taking patients to A&E in several areas.

A consequence of the problems was leading to too many patients turning up at A&E instead of using other services, with over half of the visits to some units deemed unnecessary.

The watchdog gave its backing to piloting one number for emergency and urgent care calls so that patients could be signposted to the correct service. The 999 number, however, would still be available for life-threatening situations.

However, Professor Sir George Alberti, the government's emergency care tsar, claimed most of the care offered was of a "high standard".

 

Safety improvements at Milton Park hospital

18th September 2008

An independent mental health hospital that had been identified as having breached regulations has now made significant improvements to protect the safety of patients.

The Healthcare Commission said that Milton Park Independent Hospital in Bedfordshire had made the improvements following two unannounced visits in May following an incident in April in which a patient died while on unauthorised leave.

The hospital is run by Brookdale Healthcare Limited and specialises in assessment and treatment of adults with autistic spectrum disorders received further visit in June and August.

An independent consultant forensic psychiatrist was asked by the inspection team to review the care given to the patient involved. The results showed that the care was appropriate and adequate.

Head of Investigations at the Healthcare Commission, Nigel Ellis, said: "There has been a history of problems with the services at Milton Park Hospital and we have been working with them to get those problems sorted.

"Our recent inspections identified a number of issues at the hospital that could have compromised the safety of patients. I’m pleased that most of those have now been resolved.

"Staff at the hospital have been cooperative and helpful and this has contributed towards a positive outcome both for the hospital itself and for the patients. We will be monitoring the hospital closely and if we see standards slip back in any way, we won’t hesitate to take further action, including enforcement action if appropriate."

The Commission will continue to monitor the hospital to check that the improvements are sustained.

 

Success in the war against MRSA

18th September 2008

The Healthcare Commission applauded the NHS for reducing the number of MRSA infections.

Mental health care improving

11th September 2008

The Healthcare Commission has found that almost half of community mental health patients in England are unable to access any out-of-hours care.

In a survey, the commission also discovered that a third of patients are not told about side-effects of new medication.

However, the organisation found that more patients had confidence in mental health professionals, receive copies of their care plan and have a number to contact out-of-hours in a crisis situation.

From the survey of 14,000 respondents, the majority were happy with their care. Some 78% described it as "excellent", "very good" or "good".

But the commission found that 24% were not involved in deciding what was in their care plan, and 16% said their diagnosis was not discussed with them. In addition, of the 62% of service users who did not receive any counselling almost a third (32%) would have liked to.

Healthcare Commission chief executive Anna Walker said: "The survey shows steady improvement in how service users rate key aspects of their care.

"But more must be done to improve access to care, in particular to talking therapies and out-of-hours crisis care, and to involve people in decisions about their treatment."

The mental health charity Mind expressed concern that there were still significant numbers of people with long-term health needs who were not involved in planning their care.

Liberal Democrat health spokesman Norman Lamb said people's mental health problems were being treated like "second-class citizens" too often.

But Louis Appleby, national director of mental health services, said the results showed "hugely encouraging" improvements.

 

Watchdog reviews learning disability services

28th August 2008

The Healthcare Commission is continuing to improve care standards for people with learning problems.

Controlled drugs regulations review

1st August 2008

Health services respond to Shipman inquiry with better monitoring of controlled drugs.

Survey reveals GP delays

31st July 2008

A poll by the Healthcare Commission has found many patients say they are still waiting too long to see their GP.

However, it also said that levels of satisfaction with the care offered are high from a poll of more than 69,000 people across England.

The findings did show a quarter of patients waited longer than the official target of two days for an appointment to see their GP, a further 25% said surgery hours were inconvenient and 55% had problems in getting through by phone.

Young people were also put off visiting their GP because practice opening times did not suit their lifestyle.

However, once they saw the GP three quarters of patients said their problem was dealt with "completely" to their satisfaction and 93% were treated with "respect and dignity". Most said they were given enough time to talk about their problem.

Commission chief executive Anna Walker said: "The survey shows the high regard that many patients have for the services at their GP surgeries. However, people clearly do want to be able to see a GP more easily and at more convenient times.

"It was striking that some people could not get an appointment within two days and that there are variations around the country."

The BMA GPs' Committee said that it was pleasing to see the high overall satisfaction with GP services.

GPs and the government have been locked in a row over opening times in recent months, though the Department of Health said it had spent £250m to improve access to GPs.

 

Maternity failings highlighted

17th July 2008

The Healthcare Commission is demanding improvements in maternity care after a huge review.

Public health services improving

16th July 2008

Two independent watchdogs call for renewed drive to improve public health services.

Private healthcare provider fined

11th July 2008

A company which runs an orthopaedic hospital has been fined by a court after an investigation by the Healthcare Commission.

Orthopaedic and Spine Specialty Clinic Ltd - which runs an orthopaedic hospital in Peterborough - and Mr Ahmed Shair, an orthopaedic surgeon and sole director of the company which owns the hospital, appeared before Peterborough Magistrates’ Court on July 9 and were fined under the Care Standards Act 2000 for breaching conditions of registration as a healthcare provider.

The Commission said Mr Shair was also fined on the basis that the breaches were committed with his consent or connivance, or attributable to his neglect.

The Orthopaedic and Spine Specialist Hospital provides treatment for people with orthopaedic and spinal conditions.

Under its conditions of registration, it is required to have an inpatient physiotherapy service provided by a suitably qualified physiotherapist for all those patients who properly require post-operative physiotherapy, and that no patients under 18 be admitted or consulted in the outpatient department.

Mr Shair and the Orthopaedics and Spine Specialty Clinic Ltd were found guilty of breaching both conditions.

The company was fined £5,000 and ordered to pay £10,000 towards the Commission’s costs. Mr Shair received a conditional discharge of 18 months and ordered to pay £5,000 in costs.

The Commission’s head of investigations Nigel Ellis said: “As a regulator, our number one priority is the protection and safety of patients. That’s why the government requires those carrying out certain procedures to be registered with us, and to meet the requirements of their registration.”

 

Foreign transplants concern

7th July 2008

King's College Hospital in London has been referred to the Healthcare Commission amid concerns that "too many liver transplants are being given to foreign patients".

72 foreign patients received new livers in the hospital during a four-year period. The hospital released a statement which said: "There is absolutely no truth in the assertion that patients from outside the UK can 'buy' a transplant at King's."

 

Latest heart surgery survival rates

26th June 2008

The latest heart surgery survival rates across the UK have been published by the healthcare watchdog.

The figures, released on the Healthcare Commission’s website, give information on over 35,000 heart operations performed between April 2006 and March 2007 and shows survival rates from the 37 units for all heart surgery during this period.

Figures for heart bypass and aortic valve replacement are displayed and surgeons at 30 units have also voluntarily made available the particular survival rates of their patients.

The findings reveal that survival rates have remained consistently high, with no significant change from the previous year.

In previous years, the international EuroSCORE benchmark was used to measure performance but now the UK uses its own tougher benchmark measure, reflecting the improved survival rates.

Using the UK model, there were no units with survival rates that were "worse than expected" and 32 units survival rates are "as expected".

The units at Leeds General Infirmary, Moriston Hospital Swansea, Southampton General Hospital, University Hospital of Wales and Wythenshawe Hospital, Manchester were "better than expected".

The national survival rate for all types of heart operations is 96.6%, up 0.1% on last year.

Healthcare Commission chairman Professor Sir Ian Kennedy said: "This project proves that we can successfully bring this kind of information into the public domain to the satisfaction of both patients and those who look after them.

"Some feared that surgeons may take on fewer high-risk operations, but this has not proved to be the case. In fact the opposite is true."

 

MOD asks healthcare watchdog to carry out first ever independent assessment of military healthcare

25th June 2008

Military medical service review

25th June 2008

A major independent assessment of the standards of medical care offered to service personnel at military facilities is to be carried out.

The plans were outlined by the Ministry of Defence and the Healthcare Commission after the MoD invited the Commission to carry out a review of Defence Medical Services (DMS) Clinical Governance processes.

DMS provides healthcare to 258,000 service personnel and their families in the UK and overseas and its service will be assessed against the same standards used to assess the NHS, bringing regulation of military and civilian healthcare delivery into alignment for the first time.

The review comes as the head of Britain’s armed forces Sir Jock Stirrup, the Chief of Defence Staff, suggested that military families should get preferential access to public services such as the NHS, schools and dentistry because of the sacrifices they make for the nation.

Commenting on the DMS review, Under Secretary of State for Defence, Derek Twigg, said: "The government is committed to providing a very high standard of care for our troops. That is why I have invited the experience and expertise of the Healthcare Commission to help us benchmark our achievement."

Commission Chief Executive Anna Walker commended the MoD for being proactive in the review, due to report early next year.

She added: "We now have general standards across the NHS that clearly set out the level of care expected by patients and the public. It’s only right that the men and women who risk their lives for their country can also expect that standard of care."

 

Plans announced for 2008/09

19th June 2008

The Healthcare Commission has published it plans for the 2008/09 annual health check of NHS trusts.

The aim of the check is to enable patients and the public to compare performance and identify where improvements have been made.

While the check, which has been in place for three years, is largely unchanged for 2008/09 it has been refined to put greater weight on the experience of patients and the safety and quality of care they receive.

The annual health check will see each NHS trust receive an overall performance rating in two parts – for the quality of services and for quality of financial management.

It will measure basic standards across the NHS as well as performance on indicators that matter to patients, including safety, clinical effectiveness and waiting times.

The Commission will conduct the 2008/09 health check until the end of the assessment year in April 2009 with the new regulator for health and social care, The Care Quality Commission, due to publish the results in autumn 2009.

To score well in the assessment, the Commission says that trusts will need to give greater priority to the experience of their patients and service users, safety, the quality of clinical care, and the commissioning of services.

Commission chief executive Anna Walker said: “We have listened to the views of patients, the public, clinical groups and the NHS. The fundamental structure of the annual health check remains the same.

“But we have refined the assessment to make it more relevant to different types of healthcare.?

 

Hygiene code notice for Ashford

19th June 2008

The Healthcare Commission has issued an improvement notice to the Ashford and St Peter’s Hospitals NHS Trust requiring changes to its infection control practices.

The trust was found to be in breach of the hygiene code, which sets out 11 mandatory duties for NHS trusts to reduce and control healthcare-associated infections. Specifically, its facilities to clean mattresses was inadequate and it had not made steps to assess risks associated with the use of bench top sterilisation equipment. The trust has been given until mid July to address the issues raised.

 

NHS performance cross-check

17th June 2008

The Healthcare Commission has said it will perform a "thorough" cross-check on NHS trusts' declarations on hygiene targets against other performance data.

Anna Walker, Chief Executive of the Healthcare Commission, said: “When it comes to assessing NHS performance, these declarations offer us and the public a critical piece of the jigsaw. They tell us how well NHS trusts think they are performing against the government’s standards for the NHS."

 

Trusts failing on hygiene

16th June 2008

The Healthcare Commission has said that 25% of NHS trusts in England have failed to "meet at least one of the government's standards on hygiene".

The Commission said the situation had not improved since 2007 and 103 trusts were failing to meet hygiene standards.

In April 2009, trusts will be made to reach certain targets so they can obtain a "licence for business".

Those trusts which are unable to reach the expected targets related to hygiene could have their services shut down or be run under supervision.

In April, a new body known as the Care Quality Commission will take on the responsibilities of the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.

The new figures are based on information from the 391 NHS trusts in England and relate to key targets imposed by the government in 2004.

The figures showed that hospitals had improved performance this year, but primary care trusts were not performing as well.

Of the 103 trusts that failed to meet hygiene standards 57 were primary care trusts. PCTs represented two thirds of the 70 trusts which did not reach the targets related to decontamination.

Anna Walker, chief executive of the commission, said: "Come April 2009, all NHS hospitals will have to abide by the elements of the hygiene code."

"Our summary shows trusts don't believe they are there yet. And they only have 10 months."

 

Drive to improve drug treatment

8th May 2008

A health watchdog has highlighted the need for improvements in some areas of drug addiction treatment.

In a review of 149 local drug partnerships in England, the Healthcare Commission found that there were areas that did not have adequate understanding of local need.

It particularly highlighted how access to testing and treatment for hepatitis C, where the majority of cases are associated with injecting drugs, was patchy across the county.

The commission called for a continued drive to improve drug addiction treatment to ensure services are delivered consistently across the country.

Its report, drawn up with the National Treatment Agency (NTA), revealed results from the second of three annual reviews to assess the performance of substance misuse treatment services.

It showed the number of people receiving specialist drug treatment has increased dramatically, with 195,400 in treatment during 2006/07 - up from 85,000 in 1998/99.

Estimates for 2007/08 show 210,800 people will receive treatment.

Healthcare Commission chief executive Anna Walker said that with the UK having one of the highest recorded drug-related death rates in Europe, it was encouraging that thousands more people were now getting the treatment they needed.

But the areas of concern remained over hepatitis C and access to clean needles.

She added: “Partnerships must now concentrate on driving improvements in the key areas highlighted by the review, in order to provide an equal service to all patients across the country. It is also important that partnerships really understand the needs in their area for these services and provide them accordingly.?

 

Biggest ever inspection launched

24th April 2008

Hospitals are facing the prospect of the biggest ever inspection carried out in this country to ensure they are meeting standards on infection control.

Under orders from Health Secretary Alan Johnson, the Healthcare Commission has revealed that it will inspect all 172 acute trusts annually.

The move is part of a drive to reduce death and illness from healthcare-associated infections (HCAIs), improve the experience of patients in hospital, and increase public confidence in the NHS.

All acute trusts have received letters from the Commission, calling on them to ensure that they have systems in place to minimise the risk of patients catching MRSA or Clostridium difficile.

Chief executive Anna Walker said: “The hygiene code has been in place for 18 months. Trusts know what they've got to do and previous inspections have shown that most trusts are working hard to ensure they are meeting all the requirements.

“There is a focus on infection control in the NHS unlike never before. However, if we find any trust falling short of their obligation to protect patients from infection, we will use our powers to ensure improvements are made.?

A team of infection control specialists will carry out the inspections supported by microbiologists, infection control nurses and patient representatives.

Trusts will be particularly expected to check they are meeting the 11 mandatory duties outlined in the government's hygiene code.

Ms Walker added: “We know from our previous inspections that the key to preventing and managing HCAIs is good leadership and accountability by the board, combined with an effective infection control team.?

 

Survey of NHS staff published

11th April 2008

The Healthcare Commission has today released data collected from over 155,000 NHS staff from all 391 trusts in England.

The survey showed that only 26% of staff thought the trust "valued their work" and 13% had "experienced physical violence" while at work. The Commission's Chief Executive Anna Walker said: "Trusts must continue to step up to this challenge because it is unacceptable for NHS staff...to be put in the position where they face violence and abuse as they go about their day-to-day work."

 


Ambulance service investigation

10th April 2008

A Healthcare Commission investigation has found that managers at Staffordshire Ambulance Service NHS Trust took risks with the safety of patients, staff and volunteers.

Covering the period from April 2004 to June 2007, the investigation highlighted problems at the former ambulance trust that included poor management of controlled drugs, community first responders not being adequately trained to drive at speed, and doctors employed by the out-of-hours GP service were not always GPs.

However, the ambulance services did perform well in terms of response times for emergency calls.

But the Commission felt any achievements had been undermined by a culture and approach that did not prioritise safety and that put patients at risk.

The investigating authority has stressed that the West Midlands Ambulance Service NHS Trust (WMAS), which took over Staffordshire Ambulance Service NHS Trust in October 2007, has already made progress on addressing these issues following Commission recommendations.

Commission chief executive Anna Walker said: "The managers at Staffordshire Ambulance Service NHS Trust were motivated by the best intentions - to provide high quality care for patients. However, some of the practices in the trust put the safety of patients, volunteers and staff at risk.

"Patients, staff and the public could have been seriously hurt as a result of the compromised safety culture.

"The trust sought to be innovative, and that is to be applauded, but it did not have effective systems in place to handle this innovation safely. This undermined many of the good achievements made on behalf of patients."

 

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Article Information

Title: Ambulance service investigation
Author: Martine Hamilton
Article Id: 6304
Date Added: 10th Apr 2008

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