Failures in NHS standards exposed by watchdog

Newborn baby Maternity wards were highlighted as an area of concern

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More than a quarter of NHS and social care services in England are failing to meet all the essential standards they should, the regulator says.

The Care Quality Commission inspected 14,000 sites, including hospitals, care homes and dental practices.

Among the common themes identified were staff shortages and poor management of medicines.

Maternity care as a whole was flagged up as units were struggling to keep pace with the rising birth rate.

The 14,000 inspections covered more than a third of the services the CQC has responsibility for.

Where problems were identified, managers were told to draw up action plans to improve performance. But in 130 cases the performance was so bad that the inspectors demanded urgent action be taken. In some cases this resulted in restrictions being placed on the service.

For example, a nursing home was barred from admitting new residents because of concerns over the way drugs were handed out.

The review - dubbed a market report by the CQC - is the first time data on the inspections has been published in this way.

Case Studies

Staff shortages were identified within the district nursing service run by Cambridgeshire Community Services NHS Trust. The team was only just able to respond to urgent requests for visits and the frequent moving around of staff to cover sickness and leave meant continuity of care suffered.

Inspectors identified problems with record keeping at Retreat, an independent hospital that cares for people detained under the Mental Health Act. Paper records were said to be chaotic, while inconsistencies were found when the computer and paper records were compared. It meant staff were not always able to identify the needs of patients.

At Hugh Myddelton House, a nursing home in north London run by Barchester Homes, problems with medicine record-keeping meant people were missing out on drugs. At one point supplies of some drug supplies, including pain relief, ran out for five days. Another person at risk of a stroke did not receive vital medication for two weeks because of confusion over their care. New admissions were suspended as a result.

Maternity care at Pinderfields Hospital in Wakefield was found to suffer from staff shortages, particularly during the night. It meant that some women went for long periods without being seen. Inspectors noted one incident where a woman was given antibiotics late.

It comes after criticism that the CQC had become too focused on bureaucracy to the detriment of inspecting.

In total, 27% of locations inspected failed to meet all the 16 standards covering health and care.

The report highlighted:

  • Some 22% of the 581 NHS sites were failing to meet all the requirements. Inspectors said care was being compromised by a lack of qualified staff in many places.
  • More than 850 independent healthcare providers were looked at, with 18% deemed not to be meeting all the standards. Record keeping was a common problem.
  • In social care, 28% of nearly 12,000 care homes and home care services were judged to be not up to scratch. Some of the buildings were in poor condition, while staff across the sector were said to be struggling to cope with the increasingly complex medicine regimes people were on.
  • Dental practices performed much better, with only 12% of sites not meeting all the standards. Cleanliness was highlighted as an issue.

CQC deputy chief executive Jill Finney said the report had provided a "snapshot" of performance, and the regulator would now probe more deeply into what was causing the problems.

She said similar reports would be provided every three months.

And she added: "We want providers to look closely at this report in order to assure themselves that they are taking all steps necessary to protect people from poor care."

Health minister Simon Burns said: "There is no excuse for delivering anything but the best care. By exposing poor practice and shining a light on best practice we are determined to drive up standards for everyone."

Katherine Murphy, of the Patients Association, said: "Many of these areas, in particular on matters like staffing, are heard on our helpline day after day and clearly need to be addressed not just by the trusts locally, but also by the Department of Health and the government at a national level."

And NHS Confederation chief executive Mike Farrar said: "It is important to note that the number of organisations deemed to be falling short so seriously that the most drastic action was required is small.

"However, this is another salutary reminder that the NHS must not drop the ball on caring for patients as it faces significant financial and organisational pressures."


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  • rate this

    Comment number 17.

    The NHS has become too big and too bureaucratised. It needs to be smaller, leaner and more focused. Concentrate on core medical care and stop trying to be all things to all people - there isn't enough money or time in the day for that.

    It's become a monolith that's an end in itself - the managers go to work and get paid but they don't care about delivering services. We deserve better.

  • rate this

    Comment number 16.

    The NHS was created in a very different Britain than today.
    Our ever increasing population and aging population of course is creating problems.

    The staff and system do a sterling job, but how much longer can we go on with it? What will it be like in ten years time....

  • rate this

    Comment number 15.

    Maybe it's time we remembered it's called the National Health Service and not the whole world.

  • Comment number 14.

    All this user's posts have been removed.Why?

  • rate this

    Comment number 13.

    Things are getting grim. It's not even funny how these jokers are hoping that you'll forget how this worsening service comes on the back of their reforms, before they parcel the lot off to their mates. How will "maximising shareholder profit" sound as an excuse for poor or delayed treatment?

  • rate this

    Comment number 12.

    Just another round of FUD designed to destabilise and discredit the NHS ready for complete privatisation.

  • rate this

    Comment number 11.

    I can’t comprehend the NHS being revealed to be so deplorable. They’re obviously employing people more interested in salary than a true vocation in giving care. Staff shortages would not deplete the capability a real nurse offers. Poor management and govt interference obviously does. Get rid of managers, improve medication and bring back matrons!

  • rate this

    Comment number 10.

    How on Earth can those people at the root of the "Centres of Excellence" justify the way they've allowed standards to fall; they are the same people! Their judgement cannot be trusted!

  • rate this

    Comment number 9.

    Ref -
    Don't knock it - support it. And look to the example of other countries such as the USA

    I am not knocking it - I have lived in a country without an NHS and it is not fun.

    BUT - the quality will slowly deteriorate and availability reduce as our Government continues to spend our tax money on things we did not ask for or need or simply waste it.

  • rate this

    Comment number 8.

    Health minister Simon Burns said: "There is no excuse for delivering anything but the best care."

    I have an excuse;

    The govt is deliberately underfunding the NHS so it will 'fail' and can be privatised. So, it's all going to plan really isn't it Mr Burns?

  • rate this

    Comment number 7.

    "The NHS is safe in our hands"

    Same plan as before discredit & destroy its competence, then introduce the private sector as the saviour.

    Same old, same old. I have been amazed just how much NHS is already outsourced to the private sector, whos only concern is "give me your money"

    Makes one despair.

  • rate this

    Comment number 6.

    I get so mad when the NHS get nothing but complaints! Does no one realise how fortunate we are in this country to have healthcare free at the point of need? Yes, there are problems, but none that cannot be ironed out with a few people dedicated to the NHS and not their own pockets to overhaul the system. Don't knock it - support it. And look to the example of other countries such as the USA...

  • rate this

    Comment number 5.

    Perhaps we could fund the NHS better if the UK stopped fighting ludicrous and ridiculous foreign wars all the time !!

  • rate this

    Comment number 4.

    I fear it is inevitable that some form of limited privatization is on its way. Basically, the problems are too many people requiring the NHS services, an aging population, expensive therapies and equipment and too little money. It just can't go on the way it is going or the NHS will collapse.

  • rate this

    Comment number 3.

    Take away the funding something has to give.

    Perhaps we need to take away the subsidy and expenses from MP's and see whether they improve standards in parliament.

  • rate this

    Comment number 2.

    People should remember this report when Doctor's are moaning about their pensions and the NHS unions are demanding higher pay. It just goes to prove that the so-called "Caring Professions" are not worth as much money as they would have you believe. I have had personal experience of the inadequacies of the health service. My father was treated terribly in the days before he died. It was a disgrace.

  • rate this

    Comment number 1.

    The NHS is declining the same way Dentistry did.

    It will soon be privatised by stealth.

    Doctors not doing appointments - house visits - or weekend opening.

    This will result in people having to do without or use an overloaded A&E.

    Politicians don'r give a damn they can afford private medical care.


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