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 97.

    Remind me again why we are spending £3 billion plus on reforming the NHS when we could be getting more staff to improve the current service as identified in this report?

  • rate this

    Comment number 96.

    The NHS is neither underfunded nor understaffed. It just needs to get back to providing care instead of form filling.

  • rate this

    Comment number 95.

    So much talking for so many years and yet nothing is done. What can be done is give the NSH staff a big thumbs up!

  • rate this

    Comment number 94.

    It is true to say that the NHS is different today. It was set up at a time when greed and selfishness was not the norm. People worked hard and expected little in return. The structure is overloaded with high salaried directors, managers & consultants. Change the balance, get more nurses & health professionalonion wards & work harder. More rigorous training. Put Patients first not last!

  • rate this

    Comment number 93.

    86. "Get rid of paying National Insurance, privatise all hospitals and take out health insurance. [...] The US seem to have it right."

    The US really do not "seem to have it right"! The health insurance system there is nothing short of barbaric, a classic example of rampant unregulated capitalism ruining people's lives with impunity.

  • rate this

    Comment number 92.

    Examine such apparant justifying propositions like "its costing too much," "we're all getting older " etc. Look at mortality stats for the UK, we haven't all JUST started to live longer; its not the money when we see what Banks have done. It is the WILL to have an NHS and decent care that puts a fundamental principle of social responsibility as a MUST.Profit -OUT!

  • rate this

    Comment number 91.

    With the much reported dire performance of the CQC in the recent past we can only assume the problem is in fact much worse than reported above.

    There is no doubt that the problem is the thin end of the wedge of the £2 billion, hyper bureaucratic, top down, needless reorganisation of the NHS the Tories are trying to force upon us.

  • rate this

    Comment number 90.

    We need a two tier NHS. If you work or are retired you should get the treatment you have paid for. If you have not contributed then why should you expect world class healthcare?

  • rate this

    Comment number 89.

    We need private competitive healthcare system. NHS is only good for people who use it as an Ambulance taxi, and A&E pub on Friday, Saturday nights. Shut it down. Soilders who wounded in Afghanistan should be given chance to receive treatment in abroad to save their lives. NHS with three words; bad, bad, bad. You can not provide good service for free.

  • rate this

    Comment number 88.

    Ninety per cent of these problems would be solved if there were more staff to do the caring. The trouble is that staff cost money, and the NHS will never spend money on more front line staff. So stories like this will continue to make headlines.

  • rate this

    Comment number 87.

    To all of the posters advocating a US style private system will you please watch Sicko a Michael Moore film on how the US was conned by their Govt.

  • rate this

    Comment number 86.

    We are envied across the world for our 'free' health care system but the system is at breaking point and maybe needs a radical rethink.
    Get rid of paying National Insurance, privatise all hospitals and take out health insurance. At least that way we won't be handing out free health care to all who visit our country and services may even improve. The US seem to have it right.

  • rate this

    Comment number 85.

    According to the Health Minister, "there is no excuse for delivering anything but the best care." And I suppose he's right, in that it would be needlessly dismissive to refer to perfectly legitimate reasons as "excuses".

    The problem is, they want the best care, but they want to pay peanuts for it. Is this that "something for nothing" culture I keep hearing about?

  • rate this

    Comment number 84.

    Expect the BEST from your frontline medical staff and you will get it.

    Expect the WORST from our broken "ding-dong" democractic system and its inept over priviledged greedy "gime-gime" politicians because that is what we already get.

    We, as a nation, are being CONNED.

    We have to "fight them on the beaches"... etc as one honourable Winston once said.

  • rate this

    Comment number 83.

    Privatisation is the problem. The PFI schemes introduced by the previous government are now crippling it and this government is advancing their privatisation schemes.

  • rate this

    Comment number 82.

    Re: 74.whine99

    "The NHS is not underfunded"

    Incorrect, it is both undefunded and understaffed. My friend's wife is a senior nurse and where they were previously 10 nurses in their section, there are now only 4 and one of those is part-time. They have to work all hours and even have to go in on their holidays. It is detrimental to the health of the staff and the health of the patients.

  • rate this

    Comment number 81.

    The CQC's job is to identify where standards are being met or not, so deficiencies will always be found. The scale of failures needs attention, but if, from 14000 inspections, only 130 component cases rang alarm bells loud, as other failings could be more readily rectified, it shows just how much the great majority of staff care and do. Too much wasted on grandiose IT schemes, PFI and marketing.

  • rate this

    Comment number 80.

    Why am I not surprised. I bet the figures are actually higher than those quoted. Nothing will improve anyway. I have no more faith in the new Quality Care Commission than the old Commission for Social Care Inspection. Useless and toothless. I have no faith in things improving, money or no money. The only way to fight the shortcomings is to take the issues to law. We did. It's the only way.

  • rate this

    Comment number 79.


  • rate this

    Comment number 78.

    If the NHS acted within it's original remit and stopped tattoo removal, IVF, vanity cosmetic surgery, patching up drunks, being a free service to the world's health tourists and dealing with the after-effects of people's own stupidity we'd be a lot further forwards.


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