CQC and guardians of safe working

Information on guardians of safe working and exception reporting will now be collated by The Care Quality Commission (CQC) as part of its well led domain of inspections.

The CQC has begun a soft rollout for this process, and some interviews on inspection have already been carried out. In the future, employers can expect to be asked for some of the following things in advance of their inspections:

• quarterly GoSW reports
• the trust’s quality account, including the annual report on rota gaps and the plan for improvement to reduce these gaps
• exception reports issued to the board by the GoSW regarding escalation of and serious issues unresolved.

Exclusive: CQC suspends routine inspections over winter pressures

Routine inspections of some services cancelled by CQC due to winter pressures

Regulator says decision will allow staff to focus on caring for patients

Chief executives criticise decision as a “mockery” and counter to the policy of “minimum standards”

The Care Quality Commission is suspending routine inspections of some hospitals, GP practices and urgent care services during January due to winter pressures, HSJ can reveal.

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Good clinical practice for clinical trials

How to show MHRA you're meeting good clinical practice (GCP) standards and what to expect from an inspection.  Good clinical practice (GCP) is a set of internationally-recognised ethical and scientific quality requirements that must be followed when designing, conducting, recording and reporting clinical trials that involve people.

New CQC chief inspector: We want to be friendly

The new chief inspector of hospitals has told HSJ the Care Quality Commission “wants to be friendly”, and a “strong partner” in helping trusts improve. Professor Ted Baker told HSJ: “We want to be friendly. I’ve been in some meetings in my time where the regulator comes in and it has been very confrontational. I don’t want the CQC to be like that.”
Speaking in one of his first interviews since becoming chief inspector in August, he continued: “The CQC has to be rigorous and demand high standards. It has to be clear to everyone that we will intervene if we find something unsatisfactory.
“This is not a soft touch approach, but I don’t think regulation is about a big stick as much as it is about influencing and building positive cultures.”
Professor Baker, a former medical director and deputy chief executive in Oxford, does not want providers to ”see regulators as someone that comes in and causes trouble for them when things go wrong, but [instead] as a real strong partner in helping them make sure things are getting better”, he said.
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Updates to the Single Oversight Framework: share your views

NHS Improvement is updating the Single Oversight Framework (SOF) to reflect feedback, changes in national policy priorities and developments in their oversight approach.

Tell them what you think of our proposed updates and whether they are clear, reasonable and practicable.

NHS hospitals to be assessed on how they use their resources from the autumn

Earlier this year and together with NHS Improvement, we sought your views on our joint plans to assess how NHS hospital (non-specialist acute) trusts use their resources.

The framework sets out the key lines of enquiry, prompts and rating characteristics that both CQC and NHS Improvement will use to review how effectively trusts are using their resources to provide high quality, efficient and sustainable care. As well as finance, it will include a review of workforce, estates and facilities.

The 'use of resources' assessments will be introduced from the autumn and will be carried out by NHS Improvement alongside scheduled inspections looking at the quality and safety of care, led by CQC. Following the assessment, NHS Improvement will produce a report with recommendations for improvement, if required and it will propose a 'use of resources' rating of outstanding, good, requires improvement or inadequate to CQC.

See the assessment framework from NHS Improvement.

NHS trusts tell their stories of improvement

What do NHS trusts do to turn themselves around? Our collection of case studies on eight trusts looks at the steps each one took on its own improvement journey.

Each of the eight trusts is one that has progressed from a low CQC rating to a higher one – or has left special measures, the package of support designed to help trusts with significant challenges. The eight trusts we spoke to are:

• University Hospitals of Morecambe Bay NHS Foundation Trust
• East Lancashire Hospitals NHS Trust
• Cambridge University Hospitals NHS Trust
• Wexham Park Hospital
• University Hospitals Bristol NHS Foundation Trust
• Barking, Havering and Redbridge University Hospitals NHS Foundation Trust
• Leeds Teaching Hospital NHS Foundation Trust
• Mid Essex Hospital Services NHS Trust

CQC - tell us your views on our next phase of regulation

The CQC is consulting on a further set of proposals which will help shape our next phase of regulation of health and social care in England.

For the next eight weeks, anyone with an interest is encouraged to have their say.

The proposals include:

• Changes to the regulation of primary medical services such as GPs and dentists and adult social care services such as care homes and home-care services.
• This includes the frequency and intensity of our inspections and how we monitor, provide and gather intelligence.
• Improvements to the structure of registration and our definition of ‘registered providers’.
• Further information on how we'll monitor, inspect and rate new models of care and large or complex providers.

New equality objectives to target inequality in health and social care

The CQC has published ambitious new equality objectives for 2017 - 19.  The new objectives for the next two years focus on our regulatory role in improving equality. Through our inspections, we will check that providers make person-centred care work for everyone, from all equality groups – for example for lesbian, gay, bisexual and transgender people using adult social care or mental health inpatient services. We will look at how they are meeting the new Accessible Information Standard, which applies to disabled people who have information and communication needs, for example, deaf people or people with a learning disability. We will also ensure that we communicate with everyone who contacts us in a way that is accessible for them.

The State of Care in NHS Acute Hospitals: 2014 to 2016

This report outlines the findings from CQC's first round of acute and specialist hospital trust inspects. It shows variation in the quality of hospital services but also highlights those hospital trusts that have been able to make practical changes to the way they deliver care and are seeing improvements to patient care as a result. The analysis shows variation both in the quality of care between hospitals and between individual core services within the same hospital.

See the Health Foundation's and the Patients' Association's Responses.

Hospital trusts to receive poor CQC inspection ratings for failing to involve families in avoidable death investigations

The Secretary of State for Health, has told hospital trusts that a failure to involve families properly in the investigation of avoidable deaths may result in them receiving a poor Care Quality Commission (CQC) inspection rating.

This follows the report released last week by the CQC into NHS death investigations. The report found widespread inconsistency in investigations of avoidable deaths by NHS trusts across the country. The report also found that patients’ relatives are being left in the dark during investigations about patient deaths.

In response to this report, the government has said that trusts will be required to follow a new standardised methodology and publish the number of avoidable deaths that occur at their hospitals.

Reducing infections in the NHS

Health Secretary Jeremy Hunt has launched new plans to reduce infections in the NHS. He announced government plans to halve the number of gram-negative bloodstream infections by 2020 at an infection control summit.

The government’s plans to prevent NHS infections include:

• more money for hospitals making the most progress in reducing infection rates with a new £45 million quality premium
• independent Care Quality Commission (CQC) inspections focusing on infection prevention based on E. coli rates in hospitals and in the community, and taking action against poor performers
• the NHS publishing staff hand hygiene indicators for the first time
• displaying E. coli rates on wards, making them visible to patients and visitors in the same way that MRSA and C. difficule are currently
• improving training and information sharing so NHS staff can learn from the best in cutting infection rates
• appointing a new national infection lead, Dr Ruth May

CQC launches an updated code of practice on confidential personal information

The code explains how CQC makes decisions relating to people’s confidential personal information. This includes how we decide whether we need to look at medical or care records during an inspection, and whether we need to share personal information that we hold.

Outstanding: First top ratings for NHS mental health trusts

CQC: Northumberland, Tyne and Wear NHS Foundation Trust and East London NHS Foundation Trust have become the first two NHS mental health trusts in England to be awarded overall ratings of outstanding, as detailed in inspection reports published today (Thursday 1 September).

CQC: Introduction to guidance for GP practices

This page highlights the essential and recommended reading to help you meet the regulations and prepare for a CQC inspection.

CQC: Latest tips and mythbusters for GP and dental practices

Prof Nigel Sparrow OBE is CQC's Senior National GP Advisor. Here he clears up some common myths about our inspections of GP and out-of-hours services and shares agreed guidance to best practice.

These are listed under the five key questions that we ask about services in our inspections

Joint inspections for vulnerable children and young people to focus on domestic abuse

Joint Targeted Area Inspections (JTAI) examine how well agencies work together in a local area to help and protect children.

The next series of inspections, starting in September, will look at how well children affected by domestic abuse are protected. They will include children living where there are incidents of domestic abuse, or where there is a risk of domestic abuse taking place.

Comment on the Department of Health's proposal to enable us to rate more types of provider

The Department of Health has launched a consultation on proposals to extend the types of provider registered with us that we are able to rate following inspection.

We already rate NHS trusts, general practices, care homes, hospices, home care and other types of community adult social care, and private hospitals. The Department of Health is proposing that we publish ratings for a number of types of provider that we already regulate but currently don't rate.

A Report on CQC Inspection Reports and Regulation of the Duty of Candour

This study by Action Against Medical Accidents finds that CQC inspections of NHS trusts in 2015 were inconsistent and often superficial in how they assessed compliance with the duty. The report calls on the CQC to make urgent improvements to how it regulates the duty of candour and makes several recommendations to that end.

A Spectrum Of Obstacles: An Inquiry Into Access To Healthcare For Autistic People

Following a seven-month inquiry and a consultation of over 900 people, the Westminster Commission on Autism launches its inquiry report and calls for improved access to healthcare for all autistic people. It calls for greater training of health professionals to increase awareness of the health care needs of autistic people; the implementation of annual health checks for autistic people; and also that CQC should establish autism-specific inspection questions into their inspection framework.