The must-read stories and debate in health policy and leadership.
- Today’s plea on the vaccine: NHSE ‘should publish real-time data on staff uptake by ethnicity’
- Today’s big CQC news: Trusts could get new ratings without inspection
Medway Foundation Trust is not the only hospital to have struggled with ambulance handovers over the last few months. But it has had some of the longest waiting times for handover known – with one just short of 10 hours.
The trust has come under sustained pressure from outbreaks of covid in its catchment area. The emergency department has had to ensure social distancing of patients – which can affect the offloading of ambulances. But the real issues have been poor flow of patients through the hospital and ultimately out to other settings and having half of its beds occupied by covid patients at points over the last few months.
Now the Care Quality Commission has stepped in, with a warning notice and a requirement to file weekly reports. Trust board papers suggest things are going in the right direction, with ambulance handover delays and the time before a decision to admit is made both reducing.
However, a number of HSJ readers have pointed out in comments on the article that avoiding the problems might have needed more action across the Kent and Medway system.
In what readers may deem to be better news from the Care Quality Commission, the watchdog is proposing to amend its rulebook so it can change the ratings of trusts (and other providers) without inspecting them.
CQC has substantially reduced the number of trust inspections in recent years, even before the pandemic. But that has left some stranded with poorer ratings when they feel they could have been bumped up to a “good” or even “outstanding” if they had received a visit.
It sounds like the new rules would allow the CQC to shift trusts in these circumstances up without having to afford the resources of a full-on site inspection. And, presumably, to bump them down when they feel standards have gone the wrong way – a move that may be less popular.
Among the questions raised are whether the regulator will be able to maintain what rigour and confidence its current ratings regime has, without visits. How will it judge if a trust is to go up or down, and will this lead to a general upward drift, justified or not?