Agenda item

3.            Care Quality Commission Update

3.1      Ian Brandon (Interim Inspection Manager Hospitals Directorate, CQC) gave a presentation to the Committee. The following key points were noted:

·           The CQC’s purpose is to make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and to encourage care services to improve.

·           A CQC inspection will produce a rating on the following scale: outstanding, good, requires improvement and inadequate.

·           The CQC can intervene in the work of providers in a number of ways ranging from regulatory action through to putting conditions on services and even starting criminal prosecutions.

·           After the Keogh review in 2013, the CQC changed its approach to inspections. The new inspections regime means that hospital inspection teams always include specialist inspectors, clinical inspectors and experts by experience.

·           After an inspection of a hospital, a quality summit is held with the provider and stakeholders to launch the quality improvement process.

·           Lewisham and Greenwich NHS Hospital Trust was last inspected by the CQC 18 months ago. As a result, an action plan was created to improve the care provided. The action plan contains 140 metrics. These metrics are continuously monitored by the CQC as the action plan is being implemented. 

3.2      Ian Brandon responded to questions from the Committee and the following key points were noted:

·           The CQC performs both announced and unannounced inspections. It can inspect providers 24 hours a day, and will often focus attention on the change-over between shifts. 

·           The CQC has recently acquired new powers to look at the sustainability and financial position of providers, but there is an ongoing conversation about the division of these responsibitilies between the CQC and the NHS Improvement Agency.

·           To assess the responsiveness of providers, the CQC looks at patient flow through the hospital from admittance through to discharge. It specifically looks at discharge planning, planning for the needs of the local population (e.g. winter planning and capacity planning), and shift patterns of staff.

·           In schools, a rating of indadequate can lead to difficulties in recruitment. The CQC is reviewing the impact of its new rating system for this potential issue, although it hasn’t been a problem so far. When a trust is rated as inadequate, often special measures are imposed and external support is put in place.

·           When issues of particular urgency are identified during an inspection, the CQC will raise them as soon as possible with responsible staff and this often leads to immediate changes.

·           When issues require improvement, the CQC can issue warning notices containing a deadline for change or send letters of action which highlight major concerns and ask for immediate action.

·           The CQC is an independent arms-length body that inspects both NHS providers and private providers. It has been inspecting private providers since April 2015. It’s too early to tell how private providers compare to NHS providers in inspection results. Both types of providers are required to meet the same regulatory standards. Often private providers will use different performance metrics to NHS providers so there is work ongoing to enable a comparison between the different metrics used by different providers.

3.3      RESOLVED: to note the presentation from the CQC and for the Committee to receive the CQC newsletter listing upcoming announced inspections.