HSJ Live 22.04.2015: Hinchingbrooke rating upgraded following re-inspection

5.00pm Peter Carter, chief executive and general secretary of the Royal College of Nursing, has commented on the Liberal Democrats new pledge on public sector pay (see earlier this morning).

He said: “A fully independent pay review body is the fairest way to assess pay awards for NHS staff, but nurses will be pleased to see their urgent need for an above inflation pay rise highlighted by politicians.

“The RCN has repeatedly highlighted the yawning gap between nurses’ pay and inflation, which increased throughout the coalition government to the point where nurses are now around 10 per cent worse off in real terms than they were in 2010.

“Frontline NHS staff have kept the NHS going despite increasingly difficult circumstances, and it is their pay that was targeted to save money. Now it is time to play catch up, and for the NHS to pay its staff what they deserve.

“As we approach polling day, the RCN is calling on parties to properly address the key priority of valuing nursing staff. Post election, whichever government is in place must ensure that NHS staff are at the top of the agenda.”

4.50pm Hinchingbrooke (publically operated since the start of this month) has responded to the CQC’s new inspection report.

Here’s what Hisham Abdel-Rahman, Hinchingbrooke’s chief executive, had to say:

“Today’s report from the CQC recognises the ongoing hard work and effort of staff here at Hinchingbrooke to make sure we provide high quality and safe services for all our patients, day and night.  I am pleased that our overall rating has improved and that over half of all the areas inspected are now rated as ‘good’.

“The services and areas which were inspected during this limited January inspection have all seen their ratings improve.  Those areas which were not inspected, such as whether we were ‘well-led’,  continue to reflect their rating from last September. At the time of this inspection, we had completed around one-third of our action plan to address the CQC’s concerns. We have now passed two-thirds of our milestones and have a firm plan in place to resolve all outstanding issues as soon as possible.

“We are absolutely committed to becoming one of the top-ten NHS district general hospitals in the country. To do this, we must continue to improve in many areas, not simply to address the concerns of the CQC, but so ‘good’ becomes a minimum and ‘excellent’ becomes the standard. We appreciate the ongoing support of the Trust Development Authority, local partners and our community during this time.”

3.22pm Here’s the story, so far, on the re-grading of Hinchingingbrooke Health Care Trust from ‘inadequate’ to ‘requires improvement’ after a follow up inspection: Hinchingbrooke rating upgraded following re-inspection

The Care Quality Commission has upgraded Hinchingbrooke Health Care Trust’s rating from ‘inadequate’ to ‘requires improvement’ -  but it remains in special measures.

The improved rating is based on a follow-up inspection the regulator carried out shortly before it published a highly critical report on the trust in January.

Hinchingbrooke was until the beginning of this month the only trust in the country to be operated by a private company – Circle. It returned to the NHS on 1 April.

The CQC carried out its original inspection in September 2014 and published its first report for the trust on 9 January 2015, rating it as inadequate and recommending that it be placed in special measures.

During their September inspection the CQC highlighted “serious concerns” with the trust and asked it to make improvements.

It then returned to re-inspect the trust on 2 January to “check on progress with those improvements”. At the time of the CQC’s inspection the trust was still
being run by Circle.

2.58pm CQC chief inspector of hospitals Sir Mike Richards, has also issued a statement on the regulator’s decision to upgrade Hinchingbrooke’s rating from “inadequate” to “requires improvement”.

Sir Mike said: “When we returned to inspect Hinchingbrooke Health Care Trust we found a number of improvements had been made on the Apple Tree and Juniper Wards, at Hinchingbrooke Hospital.

“We were pleased the trust had acted swiftly to make improvements to these wards and to safety in the emergency department. However, these changes need to be sustained and embedded.

“I am not recommending the trust comes out of special measures at this stage and our inspectors will return to check on what further improvements have been made at a later date.

“The trust is being supported by the Trust Development Authority with regard to its programme of improvement and CQC is also in regular contact with the TDA as it continues its monitoring of the trust.

“The trust knows what it needs to do to make further improvements and ensure those already made are maintained.” 

“At the time of CQC’s inspection the trust was staffed with NHS workers but was being managed by private company Circle Partnership. Since CQC’s inspection, Circle Partnership has ceased its involvement with the trust and it is now managed through the NHS.

“As a result of the inspection in January, the trust was rated as ‘Requires Improvement’ for whether its services were safe, effective, caring and responsive overall. It was rated ‘Inadequate’ for whether it was well-led overall.”

2.53pm Circle, the private provider which ran the trust up until 31 March when it pulled out of the controversial franchise agreement released an official statement reacting to the Care Quality Commission’s re-rating.

A Circle spokesman said: “We’re astonished. This entirely vindicates our view that the inspection of Hinchingbrooke was flawed.

“This second report is based on an inspection carried out before the CQC’s first report. We simply cannot understand why they published a critical report after an inspection that showed a different result. This was deeply misleading to patients, and will inflame the sense of injustice we know many Hinchingbrooke staff feel.

“Since our inspection, the CQC have changed their conflict of interest policy, changed the guidance for inspected hospitals, seem to have changed the publication process, retracted many serious allegations, and confirmed that they didn’t actually witness any harm to patients.

“They now appear to have changed the overall rating. That’s a victory, but calls into question the credibility of the entire inspection.

“Hinchingbrooke was the same hospital, run the same way, with Circle still in charge during both inspections. Yet in the new report the majority of 33 individual ratings are ‘good’ and just one is now ‘inadequate’.

“This fits what the clinical evidence has said all along – that Hinchingbrooke had low mortality rates, low waiting times, excellent patient feedback and positive reviews from other NHS regulators.”

2.42pm The Care Quality Commission has upgraded Hinchingbrooke Health Care Trust’s rating from ‘inadequate’ to ‘requires improvement’ but it remains in special measures.

The CQC first inspected Hinchingbrooke in September 2014, which was until the beginning of this month the only trust in the country to be operated by a private firm – Circle.

The regulator published a highly critical inspection report for the trust on 9 January 2015, rating it as inadequate and recommending that it be placed in special measures.

During their September inspection the CQC highlighted “serious concerns” with the trust and asked it to make improvements. It then returned to re-inspect the trust on 2 January to “check on progress with those improvements”.

The new report which improves Hinchingbrooke’s rating is based on that follow up inspection.

1.53pm Julian Huppert, the Liberal Democrat MP for Cambridge has said the BMA urged MPs to support the Health & Social Care Act at the second reading, causing my colleague Shaun Lintern to raise a sceptical eyebrow.

Lib Dem Julian Huppert MP says @TheBMA urged MPs to support Health & Social Care Act at 2nd reading. Really? https://t.co/ifRmZyB08s

— Shaun Lintern (@ShaunLintern) April 21, 2015

The BMA have told HSJ the briefing they issued to MPs at the time made clear their concerns with the legislation and did not advise them to support it.

1.44pm The Guardian has reported the results of our barometer survey, focusing in particular on the fact that a third of clinical commissioning groups are considering introducing limits on access, or ‘rationing’ eligibility for services this year amid huge financial pressures.

1.40pm Great Western Hospitals Foundation Trust has breached its provider licence following an investigation by Monitor.

The watchdog published its conclusion yesterday after finding that the Swindon based FT did not have a “robust” financial recovery plan or a strategy to ensure it continues to provide services for patients in the long term.

1.39pm We’ve had a comment from local government on the findings of our CCG barometer, and in particular the suspicion among CCG leaders that clinical priorities could lose out to political priorities if more responsibility is transferred to health and wellbeing boards.

Councillor Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, told our sister title the Local Government Chronicle, that the “more enlightened” CCGs recognised HWBs were partnership boards and health and local government shared responsibility for improving services. Ms Seccombe, who is leader of Warwickshire CC, said while many CCGs understood the need for change others wanted to “continue the system” as it was.

“The argument that heath keeps making that that social care is going to start stealing the money is demonstrably untrue.

“On balance over the last five to eight years local government has had to transform and had to change… We have had less money so we have had to respond to the people who vote us in and want to continue to have services, so we have been entrepreneurial about how we continue as many services as we can in different ways.

“That hasn’t happened in health largely because there are not elected representatives who are having to be accountable for it.”

12.01pm A facial surgeon has been struck off after he repeatedly punched a patient in the face during treatment to correct a fractured cheekbone, The Telegraph reports.

The General Medical Council, which brought the case against Professor Ninian Peckitt, said the unusual procedure did not cause any serious harm to the patient.

Prof Peckitt told The Daily Telegraph that he stood by his techniques and claimed he was being singled out for trying to blow the whistle on wider concerns about patient safety in the NHS.

12.00pm The head of an accident and emergency department has accused the public of using casualty like a 24-hour Tesco, The Telegraph reports.

Karim Hassan, who has worked at Royal Bournemouth Hospital for almost two decades, said he had seen annual admissions rise from 40,000 in 1999 to around 79,000 last year – an increase that could not be accounted for solely by population growth.

He said: “The actual real emergencies, the lifesaving work has not gone up that much. The way of life has changed – people do not want to wait for anything anymore.

“Gone are the days when you have a problem and wait a week or 10 days to see your GP. We have this culture where if you want something to eat at whatever time, you go to Tesco and get it. Likewise, you will have someone who, for example, has a problem with their arm and wants to have it sorted straight away because their life is busy and they want it fixed.”

He said primary care and hospitals needed to work closer together and called for the GP appointment system to be scrapped in favour of a walk-in service.

10.37am We’ve created a couple of interactive graphics on our CCG barometer findings. Check them out here.

10.31am More than 40 per cent of commissioners say their organisations are inviting competition for NHS services due solely to their concerns about controversial competition rules, an HSJ survey has found.

HSJ’s barometer asked CCG leaders if they had invited – or were currently inviting – competition for services in circumstances where they would have chosen not to but for concerns about the rules.

Eighty senior CCG leaders responded to the survey, of which more than 90 per cent were chairs or accountable officers.

The proportion of commissioners responding yes (43 per cent) increased by 14.3 percentage points from when the same question was asked a year ago, suggesting competition rules, outlined in the Health Act 2012, remain a concern.

10.17am The Liberal Democrats will make a commitment today to increase NHS pay at least in line with the rate inflation from the next financial year.

Deputy prime minister Nick Clegg said public sector workers “have made enough sacrifices” and “it is time to end the era of pay restraint”.

The party said if it is in government it will issue guidance to public sector pay review bodies to ensure pay increases at least in line with inflation in 2016-17 and 2017-18.

After that, pay review bodies will have to deliver an above-inflation rise in public sector pay.

10.07am We’ll continue poring over the findings of the barometer throughout the morning. Elsewhere, HSJ’s David Williams has produced a handy Venn diagram looking at where the political parties agree and disagree on health.

The two diagrams show where the parties’ health policy promises do and do not overlap. With the election on 7 May likely to result in a hung Parliament, any common ground on the NHS may be a vital factor in post-election negotiations between parties, and in what policies emerge.

The graphics focus on two possible scenarios. The first explores the common ground between Labour, the Liberal Democrats and the Scottish National Party – a triumvirate many experts believe will have to work together in some form after 8 May. The second examines Conservative policies compared with those of their current coalition partners the Liberal Democrats.

9.54am Another finding from our barometer - a large majority of commissioning leaders believe clinical priorities would lose out to political priorities if lead responsibility for NHS services was handed to health and wellbeing boards.

HSJ’s latest CCG barometer, carried out with law firm Capsticks, asked commissioners what they believed would be the effect of the policy, which has been floated by the Labour Party. More than half of the 80 senior CCG leaders who responded said it was likely or very likely the quality of health services would be damaged.

More than four in five thought it would result in NHS health budgets being transferred to fund social care services, and more than half thought they would be used for other council funded services.

7.00am More than a third of clinical commissioning groups are considering introducing limits on access or eligibility for services this year amid huge financial pressures, the latest HSJ survey of CCG leaders suggests.