• Routine inspections of some services cancelled by CQC due to winter pressures
  • Regulator says decision will allow staff to focus on caring for patients
  • Chief executives criticise decision as a “mockery” and counter to the policy of “minimum standards”

The Care Quality Commission is suspending routine inspections of some hospitals, GP practices and urgent care services during January due to winter pressures, HSJ can reveal.

The regulator confirmed to HSJ today that it was taking the unprecedented step to help staff focus on caring for patients. 

A small number of trusts have had planned inspections cancelled, HSJ understands. They will be rescheduled “as soon as possible”. Inspections in response to particular concerns or risks to quality will continue, the CQC said.

It is thought to be an unprecedented move.

The CQC said that through January it would:

  • Reschedule some planned routine inspections of acute trusts, based on their individual circumstances.
  • Not carry out reinspections of GP practices and urgent care services (including NHS 111, GP out of hours and urgent care centres) where they are rated good or outstanding, and where there is no information on particular concerns. Re-inspections of those rated requires improvement or inadequate will continue as planned.
  • Continue inspection of adult social care providers, which are normally on an unannounced basis in response to risks and concerns. These will be kept under review, however, and changed if CQC is notified about a particular flu or norovirus outbreak.

The CQC said: ”A normal inspection schedule is expected to resume in February but this will be subject to review based on close monitoring of system performance.”

The NHS has been struggling to cope with a huge rise in flu admissions and demand on emergency departments since about Christmas. It has left thousands of patients waiting in corridors and on trolleys for beds, while ambulances have been delayed for hours waiting to hand over patients. Performance against the four-hour waiting target is expected to have dropped year-on-year yet again, according to information from several regions.

One hospital chief executive told HSJ today the decision by the CQC “makes a mockery of unannounced inspections”. The source said it suggested that “things can go out of control with the blessing of the quality regulator in winter”.

Another said: “We are supposed to have minimum standards of care but if you’re lucky enough to have an inspection during January, you now get a pass from the regulator while others are held to the standards at other times of the year regardless of the pressures on our system.”

One junior doctor briefed by his trust on the decision added: ”It seems to me that this conveniently avoids any embarrassing reports of care in gridlocked and overcrowded emergency departments.”

Following the 2013 public inquiry report into the scandal of poor care at Mid Staffordshire Foundation Trust, health secretary Jeremy Hunt imposed new regulations on the CQC and health sector, including minimum fundamental standards. Sir Robert Francis QC, who carried out the inquiry, is a non-executive director on the regulator’s board.

The suspensions will not include the CQC’s responsive inspections, carried out where it has specific concerns about the quality of care a service is providing.

CQC chief Sir David Behan said in a statement: “As we highlighted in our State of Care report, the entire health and social care system is at full stretch – now an increase in respiratory illness and flu has further intensified this pressure.

“To support the system as much as possible, we are rescheduling some routine inspections of services. This is to allow frontline staff and leaders to focus on continuing to ensure that people receive safe, high-quality care during this period of increased demand.

”However, inspections scheduled in response to concerns about quality or safety will go ahead as planned. These include those that are in response to new information, as well as those to follow up on previously identified concerns… We will continue to monitor performance very closely and will act to protect people if necessary.

“It is important to reiterate that these pressures do not originate with and are not restricted to emergency departments, or to NHS acute trusts. As we set out in the interim findings from our first six local system reviews, this is a whole system issue, which demands a whole system response.

“The long term solution must be for health and care providers and commissioners to collaborate to provide health and social care services that meet the needs of their local population, with a stronger focus on keeping people well and helping them stay out of hospital, and on reducing variation that can inhibit people’s access to and choice of services.”