Tuesday, February 18, 2014
“Totally failed” and “not fit for purpose”. David Prior’s assessment of the performance of England’s health watchdog is damning after spending a year at the helm at the Care Quality Commission (CQC).
The regulator, which is responsible for ensuring high standards of care are upheld across the country’s hospitals, GP surgeries and care homes, has been accused of not acting quickly enough or thoroughly investigating scandals relating to Mid Stafford Hospital and Winterbourne View care home. The British Medical Association added that it had “no confidence” in the regulator last June after allegations of a cover-up over inspections at a children’s hospital in Cumbria.
But Mr Prior, who stood down as Norfolk and Norwich University Hospital chairman last year after 11 years at the helm, said the criticism levelled at the CQC had been “completely justified”.
However, he believed that the organisation had started to move in the right direction and it was his mission to restore the public’s confidence in the CQC, which was established four years ago.
Mr Prior, who still lives in Norfolk, joined the London-based organisation last February where one of his first jobs was to pick up the pieces of the findings of the Francis Report looking into the failings of the Mid Staffordshire NHS Foundation Trust, where between 400 and 1,200 more people died than would have been expected from 2005 to 2008.
He added that the findings of the report were “deeply shocking”.
“The NHS is a values-based organisation with a moral entity and it was a real wake-up call. We are building on the lessons learnt from Mid Staffs to make sure it can never happen again in any other hospital.”
“The CQC had failed totally and has not won the trust of the public or the doctors and nurses in the system. We are not fit for purpose at all. We have started to put things right, but it does not happen overnight. However, the primary responsibility of delivering high quality care is not the CQC’s responsibility, but with the doctors, nurses and clinicians. Every board in every hospital have to ask themselves ‘could it happen here?’. I do not think we can give a guarantee that bad things won’t happen somewhere in the system because the system is so big. 1.7 million people work in health and social care and we have 40,000 locations to inspect.”
The 59-year-old, who was a Conservative MP for North Norfolk up until 2001, also warned that the NHS faced going “bankrupt” if health chiefs from hospitals, community care and primary care did not work together to deliver a more community-focused model of care to cater for the country’s older population.
“The most fundamental thing is to reduce the number of avoidable emergency admissions. If they carry on rising, it is not viable and there needs to be more integration of acute care, primary care and community care.
“The traditional way has to be stopped and it has to be stopped by treating people outside of hospital, otherwise the system will be bankrupt.
“The structure of healthcare is not much different from 1948, but the population has changed fundamentally since then and the demands of an ageing and elderly population are very different from the demands of a much younger population in the 1950s and 60s,” he said.
Mr Prior, who has visited many hospitals in his role as CQC chairman said people in Norfolk were lucky to have the Norfolk and Norwich University Hospital.
“The quality of care at the N&N is fantastic – and having been around many hospitals now, I am still of that view.
“The area of weakness in Norfolk has been the failure to integrate acute, community care, and primary care and that is a real opportunity over the next five years.”
The CQC has introduced a new inspection regime and intelligent surveillance system to try and ensure it flags up problems with hospitals and care providers early.
“He added that the new inspections looked closely at the leadership of NHS trusts and social care providers.
“If you have poor leadership, everything goes wrong. If you look across Norfolk, the ambulance service have gone through a period of uncertain leadership – and the mental health trust.
“You cannot run highly complex organisations without having a fantastic leader at the top.”
Have you got a health story? Contact health correspondent Adam Gretton at firstname.lastname@example.org