Almost a quarter of NHS services are not meeting government set standards of quality and safety, according to a report published today by NHS watchdog the Care Quality Commission (CQC).
The CQC’s first full analysis of performance and risk in all health and social care providers in England is based on unannounced inspections of more than 14,000 locations.
The CQC’s Market Report is the first of what will be an ongoing series of quarterly publications looking at how the NHS, independent hospitals, social care and dental providers are performing against the essential standards of quality and safety required by law.
The ‘snapshot’ of performance shows that although the majority of NHS providers were meeting essential standards of quality and safety, 23% were not. In social care, 28% of providers were not meeting standards, nor were 18% of providers in independent healthcare.
In cases where services were not meeting standards, the CQC said it had taken action, including enforcing improvement plans and restriction or closure of services in extreme cases.
Particular themes in poor performance emerged from analysis of inspection data and what CQC inspectors believed were areas of emerging risk.
Key problem areas common to both NHS and social care included management of medicines. Around a fifth (17%) of all locations inspected failed to meet this essential standard.
Inspectors saw a worrying number of examples where the risks associated with medicines were not being properly managed, often because of a lack of information given either to those taking the medicines, or those caring for them.
Staffing was also seen to be a problem area – 11% of all locations inspected failed to meet one or both of the two standards related to staffing – and problems included numbers of staff available and the support they were given to do their job.
Record keeping – 15% of all locations inspected failed to meet this standard – was another problem area and issues included records being incomplete or not up-to-date, not being kept securely or confidentially, and not showing that risks to people had been identified and were being managed.
Safety and suitability of premises was also an issue of increasing concern to inspectors, particularly in social care.
The report focused on NHS maternity services, saying it was emerging as a problem area for a number of NHS trusts due to midwife numbers not increasing in line with demand and an increase in complex births.
CQC deputy chief executive Jill Finney said: “The data that CQC holds on performance across health and social care is unique in breadth and scale.
“Now that we’ve collected a significant amount of inspection data, we can use this information to probe more deeply into what lies behind risks in the system – this report is the first step in that process.
“CQC will use this information to help target our unannounced inspections – but we also 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.”
NHS Confederation chief executive Mike Farrar said: “The NHS is striving to comply with all the CQC's essential standards. This snapshot of the results of targeted inspection activity over recent years provides some useful pointers as to where organisations commonly fall short.”