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 57.

    17.Mrs Vee
    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
    Well said. I heard of a workshop on managing gay managers costing over £1000 per head per day. Concentrate on medical matters not running society.

  • rate this

    Comment number 56.

    PFI was a mistake, but it was an instant answer to the state it was in after the last Tory Government starved it of cash & ran it down into the ground, (as they do with anything that is for the good of all).

    It looks like they're playing a similar game, the aim privitisation by stealth.

    So it looks like the NHS will go the same way as water, trains, power, sold off to the highest foreign bidder.

  • rate this

    Comment number 55.

    1)Inspection teams have not routinely included a pharmacist since regulation became the responsibility of a national organisation. Specialist input on medicines tended to come in AFTER a problem identified rather than to prevent a problem. 2) Training for care staff on medicines is variable in standard 3) Staff turnover in Care Homes hampers achievement of standards.. Failures are no surprise.

  • rate this

    Comment number 54.

    There exists in the NHS now a fundamental conflict between those trying to deliver the core business of the trust, ie health services, and those running the trust, for whom demonstrating that health services are being provided is key. Whether any acually are, in any meaningful way, is neither here nor there.
    Trusts cook the books for the CQC. The real figure is likely much higher than 27%.

  • rate this

    Comment number 53.

    Tories change NHS. NHS does worse. Tories get watchdog to collect NHS data. Data shows NHS failing (because of tory changes.) Tories say NHS must be changed more....... NHS does even worse... and the merry loop goes round, til they can warm their hands on the bonfire they've made of our healthcare.

  • rate this

    Comment number 52.

    This is not a matter of lack of funds its a matter of how the funds are allocated. The NHS has too many managers and Qangos running it. There should be one body looking after all of the NHS and funds for care allocated fairly across the country per head not per where you live.

  • rate this

    Comment number 51.

    "42. Really
    A perfect example of NOT getting what you pay for."
    Nope; a perfect example of Government meddling, corporate skimming and biz-school management getting in the way of what it is actually there for

  • rate this

    Comment number 50.

    Let me guess, the solution for this is to privatise the NHS?

    That way we can have the same service at a higher cost, but the performance figures will be fudged so that it appears to be performing better.

    Thoroughly depressing.

  • rate this

    Comment number 49.

    The NHS is not responsible on the whole for dentists and care homes they are private care this serves as a warning for the govt any willing provider policy. If we allow staff in care homes to be paid less than supermarket employees then why are we shocked. one final point bringing back matrons will not save the NHS, doing a Micheal Gove and harking back to the past is plain bonkers!

  • rate this

    Comment number 48.

    Get rid of the 'managers' and clipboard staff and bring back a proper Matron.

  • rate this

    Comment number 47.

    What do we expect from a service that has it's morale continually knocked back?

    The NHS is starved of cash because it is treated as a business by its 'managers', in preparation for its full privatisation.

    We either allow our politicians to destroy it or we stop them!

    This is a disgusting state of affairs especially as another story on the BBC today claims billions wasted with army stockpiles.

  • rate this

    Comment number 46.

    The total value of the NHS buildings built by Labour under PFI is £11.4bn. But the bill will come to more than £70bn and will not be paid off until 2049. I think once that initial value has been repaid then payments should stop.

  • rate this

    Comment number 45.

    What are the regulators going to do and what limited powers do they have to effect change and most importantly protect vulnerable patients - the Government yet again is trying to distance itself yet the cuts and changes will only exacerbate the problems.
    Often it is the people giving the care who have impossible demands made upon them - patients should be involved in policy making and monitoring.

  • rate this

    Comment number 44.

    There's an old adage for this:

    You get what you pay for

    The NHS is under enormous cost pressure,s not least due to the Baby Boomers getting old/ill as well as the otrageous prices chanrged by the multinational drug companies......

    There isn't a lot of cash left over for actual staff who do the caring.......

  • rate this

    Comment number 43.

    Matrons tuck corners; govt cut corners, in a headlong folly to enforce privatisation. A blind man can see that.

  • rate this

    Comment number 42.

    A perfect example of NOT getting what you pay for.

  • rate this

    Comment number 41.

    Remember when managers were bought in to "solve the whole issue", they demanded huge perks and solved nothing.

    Remember being told how PFI would "solve all the issues", but the money solved nothing, and is now being withdrawn.

    I watch some commentators here with despair. Guys what will you do when you are really really sick, when your ability to protest or steer your life is compromised?

  • rate this

    Comment number 40.

    3. Charge drunks for using A & E
    4. If you take part in sports or ride a bike etc, get insurance. Break a leg for the pub team? You pay. The NHS was set up for the health of the nation not a broken toy mender!
    5. Decrimin use of drugs & get the NHS to help kick the habit. (has +ve knock on effect on crime)
    6. Employ GPs directly- close down small practices.
    7. Take health out of politics

  • rate this

    Comment number 39.

    The NHS is a battleground, its where care and respect are key but they are increasingly being scraped in favor of bureaucracy, targets and greed.
    Successive Governments have failed to protect individual citizens, and this is whats being seen in the NHS.
    No doubt profit making ideas have been discussed over private dinners and its now up to front line NHS staff to try to protect patient care

  • rate this

    Comment number 38.

    Things will only get worse, with NHS trusts having to make huge savings. Staff are being made redundant( Ward Sisters and Band 6 nurses on my wifes ward). Staff shortages have been around for many years in certain key areas, and vacant posts are now not being filled.


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