One in eight NHS trusts has been told it must urgently improve the care it provides, by a new regulator (1) publishing ratings on England's 392 trusts.(1) For 'regulator' read 'quango'.
The assessments by the Care Quality Commission show a drop in the number of hospitals meeting basic standards in areas such as hygiene and safety. But it also said more services than ever could be rated good or excellent.
From April, the CQC will gain new powers to be able to shut any of the 47 underachieving trusts down (2). The new commission, which took over the watchdog duties of the old Healthcare Commission earlier this year, pointed out a number of successes in its report. These included what it called the notable achievement of most patients in England receiving hospital treatment within 18 weeks.
The government said this was the most rigorous assessment the NHS had ever seen. NHS Ratings Health Minister Mike O'Brien (3) said the report showed improving standards across the health service. "We have transformed the waiting experience for millions of patients and now have the shortest waits on record. MRSA and C. difficile infections have been significantly reduced (4) and over three quarters of GP surgeries are providing extended opening hours (5), giving patients greater choice and more convenient access to GPs."
But shadow health secretary Andrew Lansley said the report showed the government was unable to "turn round poor performers". "Many staff are doing a great job in keeping up high standards but we cannot allow that to obscure the fact that there has been poor performance in some very important areas in the NHS, such as maternity and stroke services. And it is unacceptable that the number of patients who have had their operations cancelled has risen so sharply." (6)
The CQC looked at every type of NHS trusts, including acute, mental health, primary care and ambulance. More than half of primary care trusts were rated good or excellent, with many patients reporting being able to get an appointment within two days and services such as chlamydia screening for young people improving.
There were, however, significant regional variations, with trusts in London performing particularly poorly on patient satisfaction with appointments and opening times. Fewer mental health trusts were rated excellent or good, and some struggled to meet new criteria on collecting data about services. Ambulance services also failed to perform as well as last year, but the CQC nonetheless praised the general response to emergency calls (7). But much of the focus is on hospitals: fewer acute and specialist trusts were rated excellent, with more receiving an unimpressive fair grading.
(2) WTF? Shut down an 'NHS trust'? What does that mean in practice? Replace it with a new team of the same quangista?
(3) WTF? They have a minister just for 'rating' the NHS?
(4) After having quadrupled over the previous ten years.
(5) Compared to what? Several years ago, the government offered GPs a £6,000 pay cut in exchange for reducing opening hours and nearly all of them took the pay cut.
(6) I haven't checked this, but Andrew Lansley has always seemed pretty straight to me, so I tend to believe him.
(7) Unless they're on their lunch-break, of course.