• CQC analysis of 2016 NHS staff survey against its ratings show staff at inadequate trusts most likely to witness harm but least like to report it
  • Staff at inadequate trusts most likely to experience bullying and harassment from staff and public
  • Data suggests open reporting culture is part of what makes a trust likely to get a better rating

Staff working at NHS trusts rated inadequate by the Care Quality Commission are significantly more likely to witness harmful errors but less likely to report them, a CQC report has found.

The CQC mapped the latest staff survey results against its ratings of each hospital trust. It found that 34 per cent of staff at inadequate trusts said they saw potentially harmful errors, near misses or incidents in the last month. This was 7 percentage points higher than at outstanding trusts, and 4 percentage points higher than at trusts rated require improvement.

The staff survey was carried out between September and December 2016.

The percentage of staff saying they reported errors or near misses in the last month was almost equal between both inadequate and outstanding trusts, with 89.8 per cent of staff reporting concerns in the former and 89.7 per cent in the latter.

The data also showed that while the number of staff witnessing potentially harmful incidents falls as the rating of a trust improves, the reporting of incidents rises until a trust is rated outstanding, at which point it drops.

Staff witnessing and reporting harm at trusts, broken down by CQC rating

These findings are in line with the CQC’s view that an open reporting culture is part of what makes a hopsital better. The fall in reporting at outstanding trusts is in line with these trusts reporting the lowest level of staff witnessing concerning behaviour.

The CQC’s state of care in acute hospitals report, published this month, said: “In poorly led organisations, staff were not actively reporting concerns or learning from incidents.”

The analysis also shows the percentage of staff experiencing harassment, bullying or abuse and those experiencing discrimination was higher at trusts with a lower CQC rating.

There was a 9 percentage point difference between staff at inadequate and outstanding trusts experiencing bullying from colleagues in the past year. This difference was also seen in how the public and patients treat staff, with 30 per cent of stuff at inadequate trusts reporting abuse or harassment, compared to 25.6 per cent at outstanding trusts, 27.8 per cent in trusts requiring improvement and 26 per cent in those rated good.

The CQC report was published ahead of its board meeting tomorrow.

It also found that 14 per cent of staff in inadequate trusts reported experiencing discrimination, compared to 11.3 per cent of staff at requires improvement trusts, 11.1 per cent at good trusts and 10 per cent at outstanding trusts.

For comparison purposes, the report said that nine trusts have been rated inadequate by the CQC, 78 rated requires improvement, 43 good and five outstanding.