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HSJ Live 19.06.2013: Fallout from CQC revelations

3.30pm The Nursing and Midwifery Council’s interim chief executive and registrar Jackie Smith has been appointed to the position permanently. Ms Smith was appointed to a one year fixed term in October 2012, having acted in the role since January 2012. The appointment means neither the chief executive or chair of the challenged professional regulator is a registered nurse or midwife.

Chair Mark Addison said: “I am delighted to announce this strong appointment today, which will give us stability for the future. Under Jackie’s leadership we have started to make real progress in fitness to practise, in stabilising the organisation’s finances, and in setting out a credible plan to become an efficient and effective regulator, focused on protecting the public.”

2.51pm The debate has finished. Another tweet from HSJ’s comment editor Andy Cowper: “Former CQC CE (and current NED of Skills For Health) Cynthia Bower’s name keeps coming up in this CQC Morecambe Bay debate”

2.48pm HSJ’s comment editor Andy Cowper tweets: “Oh good - Morecambe Bay debate has turned into a party political slanging match. That’s just what the bereaved families must want.”

2.45pm Hunt says the CQC’s new focus on whether organisations are well led and a rating against that will give the public more assurance on leadership.

There will be a maximum period of one year for boards to deal with quality issues before they will be tsruck off.

2.38pm Chair of the health select committee Stephen Dorrell criticises the mamnagement of Morecambe Bay Trust for failing to share relevant information with the CQC.

2.35pm The NHS Confederation has responded to the report. In a statement attributed to a “spokesperson” they say the report is another key sign of the problems associated with the previous NHS inspection regime”.

“It is not acceptable that the CQC, which should have been the body that acted on behalf of the public, failed in its duties.

“The report indicates why we  welcome the policy proposals issued by the Secretary of State to create a new clearer role of Chief Inspector of Hospitals, a legal duty of candour for the NHS and the imminent work by the CQC to improve their inspection regime.

“The findings show that the NHS needs to change its culture. We must have a more transparent regime that operates in the interests of patients and the public. We are determined to get this right.

“We fully welcome and support the Government’s commitment to an independent inquiry into the failings of the maternity services at University Hospitals Morecambe Bay NHS Trust and the wider lessons that should be drawn from the trust’s problems.”

 2.32pm Hunt: “I have total confidence in the new leadership of the CQC… they understand that the CQC’s job is to be the nation’s whistleblower in chief.”

2.31pm One Lancashire MP reveals he has asked the police to investigate the potential attempt to subvert the FOI act alluded to in report.

2.20pm Hunt says the government is getting on with implementing the Francis report, highlighting the duty of candour. CQC chair David Prior will look at whether individuals are still working in the CQC or NHS as part of his response to his governments. Mr Hunt highlights plans for a vetting and barring scheme for managers to prevent managers found guilty of wrongdoing from working in the NHS again. He then questions the previous Labour government’s role and his role individually. “Is it the case that the head of the CQC felt under pressure not to speak out about care issues?”

Mr Hunt highlights former CQC chair Barbara Young’s evidence to the Mid Staffordshire Foundation Trust Public Inquiry that the regulator came under more pressure from the government after Mr Burnham became health secretary.

2.18pm Mr Burnham also calls for the individuals involved in the so-called cover up to be named and asks whether they are still working at the CQC or in the wider NHS. He asks if anyone from the DH or government was aware of the cover up?

2.17pm Burnham highlights that in March 2012, when the instruction to delete the internal report was given, the NHS was in the throes of a major public inquiry in which openness was a major issue. He calls on the government to get on and implement the recommendations of the Francis report.

2.15pm Shadow health secretary Andy Burnham is now speaking: mistakes happen in all walks of life but covering them up is wrong.

2.12pm Hunt describes the events at University Hospitals of Morecombe Bay as a terrible personal tragedy for all involved. He says there was a “completely unacceptable” attempt to cover up what went wrong which has “compounded the suffering” of the families.

“The whole truth must now come out and individuals must be accountable for their actions,” he adds.

2.10pm Health secretary Jeremy Hunt is giving a statement in the House of Commons on the findings of the Morecambe Bay report.

1.08pm: Meanwhile Sarah Calkin has reported on the situation surrounding the anonymisation of key individuals in the report.

1.06pm: We have published an updated, full account on the Grant Thornton report, by HSJ reporter Crispin Dowler.

12.40pm: New on HSJ: Health and wellbeing boards could be given control of more than £1bn funding from the Department of Health budget under plans being considered by ministers and local government leaders.

And, negotiations are ongoing about transferring more of the health budget to councils, HSJ can reveal.

Click here for the whole story.

12.02pm: Nigel Edwards, King’s Fund senior fellow, tweets: “Is the disgraceful behaviour at CQC designed into the regulatory system? Emphasis on managing their own risks inherent in the system”

11.40am: Unite, the union, has called for an end to the practice of face down restraint in the NHS. A statement issued today said: “Alternative methods to face down restraint need to be adopted by the NHS as a matter of urgency, says Unite, the country’s largest union.”

11.36am: Health secretary Jeremy Hunt is due to make a statement on the CQC issue early this afternoon.

11.35am: The prime minister’s spokesman has commented on the CQC revelations. David Singleton, PoliticsHome newseditor, tweets: “PM’s spokesman says claims of cover up by CQC are “deeply disturbing”. But declines to say if those responsible shd ever work in NHS again”

11.33am: We have published an exclusive story on the latest development in relation to plans to publish surgeons’ outcome data. NHS England has received conflicting legal advice on its position, HSJ was told.

11.13am: New figures from the Health and Social Care Information Centre (HSCIC) show in 2012-13 almost two million patients were treated at the scene by ambulance services without needing onward transportation, a 10 per cent rise on last year’s figure (1.81 million).

10.34am: HSJ reporter Sarah Calkin tweets from the CQC board meeting: “I would have thought a CQC report had qualified privilege [a legal status relevant to a defence against libel] but apparently CQC’s legal advice is it can’t be relied on as defence to libel”

10.32am: In other developments, Monitor has announced it has accepted the Mid Staffs special administrators request (reported by HSJ last week) for additional time toconsider the trust’s future.

Monitor says today: “The legislation specifies that the TSAs have 45 working days to identify a draft solution for the provision of services in the Mid Staffordshire area and must consult locally for 30 working days once this solution has been published. Monitor has the power to grant an extension to these statutory time periods if it considers it reasonable.

“The TSAs requested an extension last week in order to conduct further discussions with local NHS providers and commissioners, and to develop their proposals fully. Monitor’s Board has decided to grant an extension to the timetable.

“The extension means the TSAs will now have the same amount of time as health special administrators were granted by the Department of Health last year to find a solution to the problems of South London Healthcare NHS Trust. “

10.29am: James Titcombe and David Prior’s interviews on the Today programme this morning are available online.

10.23am: HSJ reporter Shaun Lintern tweets: It is important to praise CQC boss David Behan who ordered this report and has cleared out parts of the old leadership. This is positive.
“Yet again we’ve had to rely on tireless campaigning of bereaved family to get to the truth about the NHS. Well done @JamesTitcombe.”

10.17am: James Titcombe, who has led a campaign focused on investigating the failures of Morecambe Bay and the system in relation to it, appeared on the Today programme at 8.10am this morning. He called for more accountability for those responsible for the failings, in light of the report.

CQC chair David Prior also appeared, after Mr Titcombe, stressing the senior management at the time of the failings had all left.

10.13am: Debate on the CQC revelations is intense on Twitter. Macmillan Cancer chief executive Ciaran Devane, also an NHS England non-executive director, tweets: “Who on earth thinks a bad news day trumps safety, care, empathy? Well done new CQC regime though. “

10.11am: The most significant revelation from the report appears to be the decision by the CQC to cover up an earlier internal review of its actions which revealed failings.

10.09am: Sarah Calkin @sjcalkin tweets: “@KayFSheldon says she had no choice but to blow the whistle after her concerns about CQC’s and UHMB were ignored by executive, DH and SoS…

“CQC wrong to register Morcambe Bay without conditions & too accepting of assurances from trust that improvements were being made…

“Possibility individuals may claim for defamation so have not been named in GT Morecambe Bay report but referred to by job title. Hmmm…”

10.08am: The Morecambe Bay report detail was broken last night by the Daily Telegraph.

10.05am: The CQC has this morning published the full Grant Thornton report here.

10.03am: HSJ reporter Sarah Calkin is reporting live on Twitter from the CQC board meeting this morning where it is discussing the report and surrounding issues.

10.01am: The Care Quality Commission has published a damning independent report by Grant Thornton into its actions in 2010 and 2011 in relation to Morecambe Bay Foundation Trust. It reveals an apparent internal cover up of the organisation’s failings. We have a story on early emerging details here.

8.35am: The NHS Confederation has been looking at how the health service can extract more value out of its existing resources. Healthcare needs to adopt a similar approach to internet banking in order to extract more value, writes Mike Farrar, chief executive of NHS Confederation.

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