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 77.

    The NHS/Social Care (SC) currently is trying to treat to everything & everyone with an ever smaller budget. The biggest costs to the NHS/SC is manpower & low wages result in high turnover & low quality care provision. The nation needs to decide how much tax we're prepared to give to NHS/SC & what care will provided. We can not continue as we are.

  • rate this

    Comment number 76.

    No wonder the NHS is creaking under the weight of unchecked mass immigration and health tourism.

    We should take page out of the Germans play book. You only have health treatment if you've paid into taxes for over 2 years when you come to this country and nothing if you don't. Check ID's on the door. Who do you think picks up the tab? us, the tax payer.

  • rate this

    Comment number 75.

    We must protect the NHS - it is the last thing we have to be proud of. But we must cut out waste, stop paying administrators ridiculous amounts of money - I know someone paid at band 6 (up to 35K) in a regional hospital just to schedule consultant time - ridiculous for an admin person. We also need to cut out nonsense like IVF and cosmetic surgery if people want these they should pay privately.

  • rate this

    Comment number 74.

    @70 The Ace Face

    The NHS is not underfunded .... It is that the managers and groups that run the NHS do not spend the money correctly. I bet most of the managers sit in an office with thier leather bound chair and desk set which comes out of funding that is supposed to go on care

  • rate this

    Comment number 73.

    8 Minutes ago
    58 Havadram

    Conservatives started PFI, labour carried it on, after all Blair was just Thatcher lite. But please don't try to peddle the lie that it was Labours intiative.

    If you read my comment you will see that I never said that. Labour continued it and abused it.

  • rate this

    Comment number 72.

    The curse of managerialism is rife in the NHS - the per capita spend for the NHS could provide comprehensive private healthcare insurance for all and give us a little change to boot; public provision of healthcare **funding** - yes if we have to, private provision of **services**; make the patient the customer, not the government.

  • rate this

    Comment number 71.

    Folks - this is NOT about funding - it is about MANAGEMENT or lack of it. If you over-staff an organisation with managers you will have 'managers' and they are like a virus in the body - they will protect themselves until a cure becomes effective.

    Nursing quality is down to 'outsourced training' and there is only one outcome with that - see RBS for more insight.

  • rate this

    Comment number 70.

    What's to be expected if the government underfunds and understaffs the NHS and any other state-owned service? If it was doing well the government would be hardly find justification for trying to privatise it.

  • rate this

    Comment number 69.

    Far too much is expected on the NHS it should be for Medical Treatment and Care.

    Not things like IVF or Elective cosmetic surgery.

    If people want kids that bad, or new boobies, then pay for them yourself, not from my pocket!

  • rate this

    Comment number 68.


    A lovely thought but it won't happen - most of the beaurocracy in the NHS is because of the terrible way we Brits are so quick to sue for anything.

    Without a paper trail to prove you did nothing wrong in the vast majority of claims the NHS would be found against all the time instead of just occasionally when they do mess up......

  • rate this

    Comment number 67.

    I bet the gauze being drawn over our eyes that there’ll an abundance of NHS managerial meetings today, to puff up their egos over coffee and biscuits. They’ll march about armed with clipboards, looking like the ridiculous excess to requirements, and drain on the NHS they are.

  • rate this

    Comment number 66.

    Gov't UK plc has failed this country on a scale that is incomprehensible. Just like the tiers of NHS middle management that were created a few years ago. The only thing any of them have been successful at is securing their own snouts in the trough at the expense of everyone else and now the current bunch are so busy asset stripping the country and selling it of to their rich chums to give a damn

  • rate this

    Comment number 65.

    Until you get people who understand how to shop around and don't just buy the first thing, then we have no chance.

    The real problem is the altitude of 'it's not my money' syndrome.

  • rate this

    Comment number 64.

    Ah, so the rising birth rate is whats causing strain on the NHS, not smokers, drinkers or obese people, but people fornicating, lol, love it :)

  • rate this

    Comment number 63.

    Labour brought in Private hospitals which it was obvious that they were not going to work ie £300+ to change a light bulb!! The birth rate is far too high,how many are from immigrants inc illegals. Some come in especially to have baby then allowed to stay to live on benefits for life. There is lack of management skills. Are they on bonuses, if so another example of why this system needs to end

  • rate this

    Comment number 62.

    Just now
    When I go abroad I have to make sure I have adequate health insurance to cover me for treatment - If I havent I would have to pay for any treatment received. Why isn't this implemented in the UK for all visitors coming to the UK ...Just another of many examples of how NHS money is drained

  • rate this

    Comment number 61.

    58 Havadram

    Conservatives started PFI, labour carried it on, after all Blair was just Thatcher lite. But please don't try to peddle the lie that it was Labours intiative.

  • rate this

    Comment number 60.

    The government seem to hell bent on cutting funding and workers in order to create better services. Where do you stop? One hospital and one NHS worker
    The queue is going to be very long....

  • rate this

    Comment number 59.

    The NHS would function to expectation if it wasn't lumbered with dealing with society's woes. When I was in hospital many of the patients were not there for medical treatments but simply because there was nowhere else for them to go. Similarly the NHS is not there to deal with the treatment of self-inflicted conditions such as drink, drugs, smoking and other seedier sides of living today.

  • rate this

    Comment number 58.

    Labour fully supported PFI, saying that the private sector could do a better job than the public sector. We are now seeing the results of that with some health trusts spending a fifth of their budgets on repayments. Any apology for that one Ed?


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