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 437.


    ER bills you... Well shock horror.

    You have to pay for a service you receive? Who'd have thought it?

    Taking something without paying is called stealing.

    The US system of employers providing med insurance rewards work and ensures that workers don't bear the cost of layabouts.

    US has its faults, but at least it's a culture that stigmatises laziness, instead of rewarding it.

  • rate this

    Comment number 436.

    The NHS is being compromised by servicing the PFI schemes (privatisation) and unreasonable funding cuts by the government. Tax payers money should be used to provide healthcare for the citizens of the country and not to enrich big business.

  • rate this

    Comment number 435.

    371 Mayna
    Ok, then let me ask you a question, when the Dentists dumped all their NHS patients , was a precedent set? did NHS dental treatment come to an end? .Finally, why do you think the GPs "resolutely refuse" to become employees the NHS ?

  • rate this

    Comment number 434.


    @174.Lucy Lastic

    You are so clueless I don't even know where to start. No wonder the public sector is in such trouble with people like you working for it.


    I worked in the PRIVATE sector for over 40 years

    Just goes to show how sad your rant is. Like most Tory boot boys you have no understanding of the world outside your myopic haze of Rightwing Rags. I obviously struck a nerve.

  • rate this

    Comment number 433.


    Yes, it'd be "tough". That's with no hesitation at all.

    I don't take anything I haven't earned. I'm not a scrounger. Britain's tolerance of workshy layabouts is truly astounding.

    As a taxpayer, I resent paying for anyone who doesn't pay their own way. Socialism failed globally, damned near bankrupting most of it, and it's time we all lived in the real world. Pay our way. Have some pride.

  • rate this

    Comment number 432.

    Passive seems to describe most quangos/'watchdogs.

    I sought help from Air Users Council when a budget Airline refused to pay the compensation I was due - useless, utterly pointless.
    I took court action myself and won.

  • rate this

    Comment number 431.

    I agree the NHS needs to be less bureaucratic. Involvement of the CQC only increases bureaucracy. Endless action plans, the need to constantly prove what you're doing, leaving you less time to do it... 'Standards' have to be measured and measurement means lots of paperwork that doesn't in itself improve care. There's next to no time left to actually do anything to develop the service,

  • rate this

    Comment number 430.

    The Care Quality Commission seems to be a passive commentator.All it seems to do is to comment on existing trends and failings, instead of proactively preventing failings by rigorous inspection procedures.Surely as the Regulator which has operated for over 3 years now, it must start to take responsibility for continuing to allow poor practice to flourish.

  • rate this

    Comment number 429.

    My Grandad, decorated WW2 pilot, great father, husband, and grandfather to me, has started to deteriorate in age. He was in hospital a bit - treated him like dirt. They left him to rot in his own filth until we got him out.
    My aunt, a distinguished nurse of 30+ years service, is messed around by ambitious idiots to whom patients mean little.
    "It's the goverments fault" doesn't cover all of it.

  • rate this

    Comment number 428.

    Wonder if the watchdog could expose Mr Lansley's collateral damage register?

  • rate this

    Comment number 427.

    Haven't we imported enough corruption greed and double standards from the US - not to mention Bob Diamond and Murdoch the Manipulator.

    Fox, Gove Cameron Hague - all infatuated with US social model - the one that embraces greed, deception and hypocrisy whilst viewing morality as an affliction

    US 'healthcare' approach represents the bottom rung of the ladder - to be avoided like the plague

  • rate this

    Comment number 426.

    423. Starry Maz

    Correction - typo - should read £2.5k per wk. Bad enough huh?

  • rate this

    Comment number 425.

    You want something, you pay for it (or insurance). Thats how the world should be. If you can't afford it, tough."

    So how would you manage if you acquired a chronic, degenerative illness or an uninsured driver rendered you permanently immobile or you had a child with a genetic illness? You certainly couldn't afford the healthcare and no one would insure you, so would that be "tough"?

  • rate this

    Comment number 424.

    Wait in an NHS A+E dept 3 hrs +
    Wait in a French hospital on holiday - none at all, seen immediately."

    Well, France does spend about 25% more on its healthcare than we do and pays its doctors a lot less than we do so there's then more money for treatment and they can employ more staff. They also charge to see a GP which reduces time wasters.

  • rate this

    Comment number 423.

    Our experience of CSCI a few years ago was utter complacency. Tho raising many serious shortcomings in a private hospital funded by the taxpayer £25k a wk 10 yrs ago, had to use all my will to get them to pursue my complaints. The result, a whitewash, guilty as those they were meant to monitor to the detriment of those they were meant to protect! Unlike Marie, I couldn't get any solr to represent

  • rate this

    Comment number 422.

    Anyone see the Panorama on Greece? No healthcare, no hope. Here soon.
    In the land-of-the-free-sorry-america 50% have NO HEALTHCARE - welcome to the "Private sector".

  • rate this

    Comment number 421.

    Too much of a easy target for any slimy politico to feather their nests with - this PFI madness - PRIVATE was a big clue.
    The government are running the NHS down in order to boost profit (from anyone left with money) to their dodgy mates.
    Or am I wrong and the govt. are actually helping somebody but their own?

  • Comment number 420.

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

  • rate this

    Comment number 419.

    Huge increases in red-tape have mainly occured because patients and relatives are more ready to sue - litigation costs are soaring."

    £257m in 2011. Practically zero before 'No Win, No Fee'. Same as with car insurance, I expect many payouts are made simply to keep the costs down. I don't really believe doctors have suddenly got more negligent, but it can be too easy to sue.

  • rate this

    Comment number 418.


    Huge increases in red-tape have mainly occured because patients and relatives are more ready to sue - litigation costs are soaring.

    Whose fault is this? Partly the NHS as mismanagement and clinician errors do occur but with the prospect of potential easy money, patients/relatives have nothing to lose. Also explains the ever-increasing numbers of well-paid NHS managers.


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