Trusts rated well by the Care Quality Commission tend to have better scores in the NHS staff survey, HSJ analysis has found

Patients’ opinions on the quality of care also appear to be closely linked to trusts’ CQC ratings.

Analysis of all 84 trusts from all sectors rated by the CQC by this quarter found that the average percentage of staff who recommended the care delivered by their organisation varied by nearly 40 percentage points between the trusts in the lowest category and those in the highest.

The nine trusts rated “inadequate” at the time HSJ conducted its analysis had an average of 51 per cent of employees recommending the trust’s care in the 2014 NHS staff survey.

This compared with an average of 88 per cent at the two trusts rated “outstanding” by the CQC to date: Frimley Health Foundation Trust and Salford Royal Foundation Trust.

The 48 trusts rated “requires improvement” to date had an average of 60 per cent of staff recommending their care. The 25 “good” providers had an average 70 per cent recommendation. It is considered an indication of organisations’ staff culture.

HSJ also compared the CQC ratings with data from the 2014 CQC acute inpatient survey, published last month, which covers 69 trusts in our analysis.

This survey asks people about different aspects of their care and, based on their responses, gives trusts a score out of 10 for each question, where the higher the score the better.


At trusts rated ‘outstanding’ by the CQC, 88 per cent of staff would recommend the care

For the question about inpatients’ overall experience of a trust’s services, “inadequate” providers fared worst in the survey, with an average score of 7.8.

Trusts rated “requires improvement” had an average score of 7.9, “good” trusts averaged 8.1, and the two “outstanding” trusts scored 8.7.

As well as staff and patient survey results, there also appears to be a link between acute trusts’ mortality rate indicator and their CQC ratings.

Trusts rated “inadequate” had an average summary hospital mortality indicator of 1.06 – meaning there were 6 per cent more deaths than expected.This compares with an average of 0.99 for trusts rated “requires improvement”, 0.98 for those rated “good” and 0.96 for the two “outstanding” trusts – meaning there were 4 per cent fewer deaths than expected at Frimley Health and Salford Royal.

CQC deputy chief inspector of hospitals Edward Baker told HSJ the regulator viewed the NHS staff and inpatient surveys as “important sources of information about the experiences of those who work in the system and who use NHS services”.

“Our analysis of the question ‘Would you recommend this trust?’ found that a below average score was often associated with a ‘requires improvement’ or ‘inadequate’ rating,” he said.

“A well led NHS trust will reflect on their own results in these surveys and will make sure that they respond effectively to the views of patients and staff.

“The results in such surveys are just one of several types of evidence that we analyse and consider to help guide our inspection teams on their visits and make sure that they get to the heart of any problem areas.”

Analysis: CQC ratings align with staff satisfaction