Confed proposes peer review to avoid Mid Staffordshire repeat

The confederation has proposed a series of steps that should be take voluntarily in response to the “appalling” care at Mid Staffordshire trust revealed by the Healthcare Commission last month, while warning against the introduction of stricter regulation and compulsory checks.

Confederation policy director Nigel Edwards said regular peer reviews would be an additional external check against failure, but would avoid taking responsibility away from boards.

He said: “The more you make something an external responsibility there is a danger of undermining that [board responsibility].

“Getting yourself peer reviewed because you want to do it seems to me much more likely to lead to improvement than ticking more boxes.

New light

Peer review means you also bring new ideas back and see things that make you look at your own practice in a different light.”

Mr Edwards said that, though not compulsory, those deciding against it “should be expecting to get rather more external scrutiny”.

In addition, he said in some cases commissioners needed to improve their scrutiny of providers’ quality, particularly by visiting them and talking to their clinical staff.

Mr Edwards said trusts should make sure they were listening to the views of patients and the public, which should be aided by the introduction of quality accounts. Staff should also be encouraged to raise their concerns about quality and safety.

Two reviews are being carried out into the events at Mid Staffordshire foundation trust for the Department of Health, including the role of NHS West Midlands and primary care trusts, and the national quality board is considering how a repeat can be avoided.

Mr Edwards said any proposals should focus on the “systemic” issue of how boards operate.

“Regulation is only ever a backstop - the bottom line is the board. The danger is with more intrusive regulation you disempower the board and make it a box ticking exercise.”