The Care Quality Commission is today launching sweeping changes to its inspection regime, and introducuing Ofsted-style ratings which it says will better protect patients, and ensure hospitals are scrutinised “from top to bottom”.
Prof Sir Mike Richards, newly appointed chief inspector of hospitals, said he was now attempting to recruit at least hundreds of inspectors, including hospital patients and their carers, so that future inspections have a wider range of perspectives, and give a voice to those who are treated by the NHS.
He said patients from all across England could apply to be recruited to a lay role, but that they would be unlikely to be allowed to inspect their own local hospital, in order to ensure the process was not biased.
The first inspections using the new approach will begin in about a month, with 18 hospital trusts selected to pilot the new approach.
The trusts have been assessed under 150 measures - including the number of avoidable infections, the number of safety incidents so serious that they are called “never events” and levels of complaints - and been ranked as high or low risk, or somewhere between the two.
Sir Mike said Barking, Havering and Redbridge University Hospitals trust, Barts Health trust, Croydon Health Services trust, Nottingham University Hospitals trust, South London Healthcare Trust and The Royal Bournemouth and Christchurch Hospitals Foundation trust had now all been assessed to be “high risk” based on such findings - though no trust will receive a rating until it has been inspected.
The 14 trusts with recent high mortality rates, which were yesterday identified as failing thousands of patients will not be inspected, because they have just undergone a similar process.
However officials said death rates would form part of the risk rating of each trust, so that in future those with high mortality rates and other patient concerns would be inspected more urgently.
Sir Mike said: “Today am issuing a call for inspecctors - I want assistance. I want to start building a small army of insepctors and they need to come from all walks of life. Some will be practicising doctors .. or retired health professionals but we are also seeking patients and carers.”
He said patients would be paid a day rate - not yet agreed - for their time, plus expenses, because a “50 mile rule” was likely to be introduced so that nobody inspected a hospital at which they worked or were likely to be a patient.
“My job is to the put the patient at the heart of this,” Sir Mike said.
Officials said the new approach would replace a widely discredited model, which relied heavily on self-assessment by trusts, and meant that inspection visits would only focus on small parts of a hospital at a time.
Until now, the inspection regime meant that a hospital could get a good report based on a visit to its maternity unit, when its Accident & Emergency department was putting lives at risk.
Sir Mike said those leading the CQC “recognised that it was flawed”.
He said: “It tended to focus on individual specifics of care what we wil be doing is looking at how well care is being delivered across a hosptial from top to bottom.
Core services - including A&E, care of the frail elderly, maternity, and paediatrics would always be inspected on every visit, which would involve at least 15 inspectors and take at least two days, and longer for larger sites.
He said that while hospitals would be given notice of some visits, others would not be “unannounced”. Trusts would be likely to know that they were being inspected, but not what day or week inspectors would arrive, in order to detect staff shortages at times when hospitals were likely to have fewer people on duty.
Sir Mike said: “In the end, [the question is] would I be happy if my mother, my brother, my niece or my great nephew went to this hospital - it covers the whole age spectrum.”
Asked about the CQC’s history, with a report last month accusing its former leadership of presiding over a “cover-up” and political rows about Labour’s handling of the NHS, Sir Mike said he hoped his track record, working as National Cancer Director under the past and current Government, showed his independence. He said: “ I have worked for two administrations and seven secretaries of state - my job is to the put the patient at the heart of this.”