|
I agree with Wes…
There, I bet you never thought you’d hear that…
… I do, I agree with Wes.
He’s right. The CQC is a basket-case. Has been for a long, long time. I know it. You known it. Trusts, GPs, everyone including the Confed and Providers know it.
The CQC have form. In 2013 a report by Bruce Keogh revealed the state of some hospitals... just like today, the CQC hadn't improved anything and hadn't kept us safe, but the CQC carried on regardless.
And more...
Next question; if it’s been a basket-case for so long, why hasn’t anyone done anything about it.
Three reasons;
First, the inspected-organisations are, for obvious reasons, terrified of reprisals.
So, they say nothing.
Second, for politicians to say I want to call-time on the CQC, is tantamount to saying ‘I’m not interested in quality’.
So, they say nothing.
Third, the CQC is the equivalent of the NHS’s municipal tip. Anything that looks iffy is dumped on them. It's handy.
So, nothing gets done.
The Dr Dash’ (an ICB chair with links to McKinsey), interim report, that’s caused the furore, was dashed-off in about eight weeks. What’s it say?
Here it is.
Poor inspection, poor staff, poor responsiveness, poor management. Delays, poor leadership, inconsistencies, inaccurate, lousy IT, quality hasn’t improved… you could have written it yourself.
Think about the all maternity failings there’ve been.
There are four immediate steps:
Professor Sir Mike Richards to review CQC assessment frameworks… he was the CQC’s first chief-inspector. Appointed in 2013, retired in 2017.
No!
Nice man, a cancer expert but appointing him is like telling turkeys you’ll cancel Christmas but carry on with Thanksgiving. We must stop inspection. Start using data to support problem Trusts. A fresh look. Fresh eyes.
Improving transparency… how the CQC determines its ratings.
No!
Ratings are out of date a soon as you create them. One or two word ratings for a Hospital with 150 specialties, thousands of people and goodness knows whatever-else-complexity, is bonkers… demoralises everyone.
Increased government oversight of the CQC.
No!
They’re an arm’s length body. They have to be independent or nothing works.
Dr Dash to review the effectiveness of all patient safety organisations. There are well over a hundred organisations that can ‘inspect’ hospitals. None of them make the NHS safer…
… good luck.
We know inspection doesn’t work.
Turn up, inspect and everything’s good… you’ve wasted yer time.
Turn up and it’s bad… yer too late… the damage has been done.
When Richards left his post at the CQC, after nearly five years of inspection, the British Red Cross described the situation in England's hospitals as a "humanitarian crisis”.
Stepping up inspections?
Yer 'avin a larf. No!
The CQC, in fees charged to hospitals, GPs, ambulance services and others has taken £230m out of the front-line.
Depending on the size of the unit, anything upwards of 50 inspectors can arrive in a charabanc, each with hotel, travel, training, admin and salary costs.
More inspections means more people inspecting. Soon, half the NHS will close down whilst the other half inspects it… to what purpose?
The NHS has more data than Custer had Indians.
We need a zero based start to regulation and quality.
A modern organisation. Swap inspectors for analysts and data experts.
A learning organisation, sharing best practice. Swap inspectors for coaches and support systems. Peripatetic groups to supplement management.
A risk-based organisation, analysis, forecasting where problems are likely to occur. Fixing problems before they erupt…
… and a recognition; no one comes to work in the NHS to do a bad job. Things go wrong when there aren’t enough properly qualified people, not enough capacity and inputs are confused with outcomes.
We can integrate data, make it interoperable. Use it for predictive outcomes for patients, including hospital acquired infections, resource allocation, excess deaths and management. Proactive maintenance, chronic disease management, identify at risk populations, staff-turnover and sickness, patient complaints, overheating health economies, optimising patient flow…
… and you know what? It’s all available now. We can do it now... today.
Triangulate; complaints, excess deaths, staff churn and sickness, throughput, budget deficits... and you'll know where the problems are likely to be.
Streeting has the perfect opportunity to show us he means to make a real change. Make patients properly safe. Stop stumbling around asking 'what happened', when failure comes knocking.
The NHS should be a safety critical industry instead its a confused business with out-of-date methods and old fashioned ideas.
Do not let this spectacular failure go to waste.
It’s an opportunity to start again… intelligently, data driven and with a purpose to show the rest, what the best can do.
| 
