Safety across the NHS and care sectors in England is a “significant concern”, with particular problems in hospitals, inspectors are warning.
The Care Quality Commission found three-quarters of the 79 hospital trusts visited under its new inspection regime so far had safety problems.
Over 40% of care and nursing homes and home care services and one in three GP services also had problems with safety.
Lack of staff – in terms of skills and numbers – was identified as a major issue.
The way medicines were managed and how mistakes were investigated and learnt from were also highlighted.
Among the individual cases flagged up were:
- A&E patients being kept on trolleys overnight in a portable unit without proper assessment
- Staff at a GP surgery not undergoing basic life-support training in the past 18 months
- Medication mistakes at a care home – including delays giving drugs and signs of overdoses
The findings – contained in the CQC’s annual report – are effectively a mid-term update of the new tougher Ofsted-style inspection regime.
They cover the first 14 months of the inspection programme, which was launched in April 2014 and is expected to be largely completed by April 2016.
So far more than 5,000 organisations have been inspected – nearly half of hospitals, 17% of care services and 11% of GP surgeries and out-of-hours providers.
However, those deemed most at risk have been predominantly targeted first, so the level of failure is not necessarily representative of the overall sector.
- 47% of hospitals inspected
- 17% of social care services
- 11% of GP services
During the inspections, CQC experts look at a range of different issues, including the quality of management, whether staff are caring and safety.
Each organisation – from GP surgery to hospital – gets a rating for each, resulting in an overall rating of inadequate, requires improvement, good or outstanding.
The results of these are widely published throughout the year, whereas this report looks at some of the common problems identified during the whole process.
Of all the issues looked at, the CQC said most concerns had been raised about safety.
Some 13% of hospitals were judged unsafe, 10% of social care services and 6% of GP services.
Once those judged to be not safe enough are included, it brings the numbers with safety problems to 74% for hospitals, 43% for social care services and 31% for GPs.
The Health-Care Survivor’s Comment
Regular readers will not be surprised that I find this report, both deeply disturbing, and yet unsurprising. My life’s story has been intimately entwined with that of the NHS. I have said before, that I have benefited and suffered, in equal measure, from the medical systems of the three countries in which I have lived.
Over the last decade, I have noticed a clear shift of focus, within the structure of the NHS, away from individual interactions between clinicians and patients, at a human level, towards the implementation of processes, and inflexible protocols. From a personal perspective, this has been most noticeable, and regrettable, in my experience of receiving nursing care.
When human collaboration, and compassion are being timed-out, and actively discouraged by the drive for cost-cutting, dressed up as efficiency, it cannot be a coincidence that patients have become, and certainly feel, less safe.