The state of care in independent doctor and clinic services providing primary medical care

Care Quality Commission | March 2019 | The state of care in independent doctor and clinic services providing primary medical care

The state of care in independent doctor and clinic services providing primary medical care, presents the CQC’s findings from their analysis of  sample reports (85 inspection reports for independent doctor and clinic services and themes from a review of inspection reports for 38 independent slimming clinics) from their inspection programme. This analysis showed that many services were responding to the needs of patients, some however were not meeting regulations and not providing safe and effective care. 

The caring key question had the most positive feedback and fewest concerns, whereas most concerns fell under the safe key question. CQC’s main areas of concern related to:

  • safe and effective prescribing
  • awareness of safeguarding and establishing patients’ identity, particularly for children and their parents or legal guardians
  • arrangements for clinical oversight, governance frameworks and quality monitoring and improvement
  • recording details and managing patients’ care records
  • gaining appropriate consent
  • sharing information with a patient’s NHS GP or other health professionals in accordance with guidance from the General Medical Council (GMC)

On re-inspection, providers showed improvement in a number of areas where we had found concerns. Where they did not, CQC have taken the necessary enforcement action (Source: CQC).

Read the press release here

The state of care in independent doctor and clinic services providing primary medical care

CQC: Learning from deaths- a review of the first year of NHS trusts implementing the national guidance

Care Quality Commission | March 2019 | Learning from deaths- a review of the first year of NHS trusts implementing the national guidance

The Care Quality Commission (CQC)  have published Learning from deaths- a
review of the first year of NHS trusts implementing the national guidance
. The CQC conducted  qualitative interviews and held a focus group  with with CQC inspection staff and adivsors; alongise this they also carried out case studies within trusts rated as ‘outstanding’ for being well-led between September 2017- June 2018. CQC identified variation in how the new guidance was implemented in trusts.

learnign to do better cqc.org.uk
Image source: cqc.org.uk

In light of their findings, CQC have suggested the following factors have an impact on how the guidance is implemented:

  • values and behaviours that encourage engagement with families and carers
  • clear and consistent leadership
  • a positive, open and learning culture
  • staff with resources, training and support
  • positive working relationships with other organisations (Source: CQC)

Learning from deaths : Easy read

Learning from deaths 

New research for CQC shows people regret not raising concerns about their care – but those who do raise concerns see improvements

Care Quality Commission | February 2019 | New research for CQC shows people regret not raising concerns about their care – but those who do raise concerns see improvements

The Care Quality Commission (CQC) is encouraging people who have concerns about their care to raise concerns. According to their research 7 million people in England who have accessed health and social care during the last five years have concerns about their care but have not raised them.  More than half (58 per cent) expressed regret about no raising concerns (Source: CQC).

Declare your care
Image source: cqc.org.uk

The main explanations given for raising a concern were:

  • delays to a service or appointment
  • lack of information
  • poor patient care

Reasons cited for not raising a concern were:

  • Not knowing how (20 per cent)
  • Not knowing who to raise it with (33 per cent)
  • Not wanting to be seen as a trouble maker
  • Worried about not being taken seriously
  • More than a third (37 per cent) felt that nothing would change as a result of raising a concern

Although when concerns were raised two-thirds found their issue was resolved quickly.

The findings have been published to coincide  with the CQC campaign ‘Declare Your Care’- which is encouraging people to share their experiences of care with CQC to support its work to improve standards of care in England.

Read the full press release from CQC

Survey data can be downloaded from CQC 

Related:  CQC ‘Declare Your Care’

Many women are positive about their maternity care but improvements still needed

CQC | January 2019 | Many women are positive about their maternity care but improvements still needed

The Care Quality Commission (CQC) has published its findings from  a national survey of more than 17,600 women who gave birth in February last year, it shows that many had a good experience, particularly in relation to interactions with staff, access to midwives and emotional support during pregnancy.

However, for some women the care they received fell short of expectations with issues highlighted around continuity of care, choice in antenatal and postnatal services and access to help, information and support after giving birth.

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The findings highlight women’s views on all aspects of their maternity care from the first time they saw a clinician or midwife, during labour and birth, through to the care provided at home in the weeks following the arrival of their baby.

Nationally, there appears to be a limited improvement in women’s experience between 2017 (the last time the survey was carried out) and 2018 and in some areas women’s experience has declined. However, several areas continue to show positive results over time when compared to results from the 2013 and 2015 surveys.

Overall, women reported positive experiences for many areas of their maternity care in 2018, this includes:

  • being asked how they feel emotionally during antenatal care
  • feeling listened to by midwives during antenatal check-ups
  • being spoken to in a way they understood during labour and birth
  • having confidence and trust in the staff caring for them
  • being treated with respect and dignity
  • their partner (or someone else close to them) being involved during labour and birth

However, while there had been small improvements across most questions from 2013 to 2017, very few questions showed this trend continuing between 2017 and 2018, with some questions showing a decline.

This includes women’s experiences of:

  • being given enough information about emotional changes which may be experienced after giving birth
  • being visited by a midwife at home after giving birth
  • seeing a midwife often enough at home after giving birth
  • staff awareness of the mother and baby’s medical history
  • being given enough information about their physical recovery after giving birth

(Source: CQC)

Read the full press release from CQC here 

Maternity services survey 2018: statistical release

Maternity services survey 2018: Quality and methodology report 

In the news:

OnMedica Maternity care better in some respects – but still many problems

NHS Safety Culture: Opening the door to change

Care Quality Commission | December 2018 | NHS Safety Culture: Opening the door to change

The CQC collaborated with NHS Improvement to look at issues in NHS trusts that contribute to Never Events taking place. These are incidents with the potential to cause serious patient harm or death that are wholly preventable if national guidance or safety recommendations are followed.

 

opening the door
Image source: cqc.org.uk

Their review sought to answer 4 questions:

  • How do trusts regard existing guidance to prevent Never Events?
  • How effectively do trusts use safety guidance?
  • How do other system partners support the implementation of safety guidance?
  • What can we learn from other industries?

To this end the CQC visited 18 NHS trusts (both acute and mental health) during April and June 2018. They conducted one-to-one interviews, visited different services and reviewed policies and procedures.

CQC also consulted aviation, nuclear and fire and rescue industries to understand other safety-critical industries’ approach to safety.

Although patient safety alerts are generally seen as an effective way to share safety guidance, the context in which they are landing creates challenges for trusts. The report identifies challenges faced by trusts, by the health system as a whole, and in educating and training staff (Source: CQC).

Full news release from CQC 

Opening the door to change 

Opening the door to change Summary

Related:

NHS Improvement Never events data 

CQC publish findings of health and social care services in Leeds

Care Quality Commission | December 2018 | CQC publish findings of health and social care services in Leeds

The Care Quality Commission (CQC) has published its findings following a review of health and social care services in Leeds.

This report is one of a number of targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together.volunteer-2055015_640.png

As part of the review, CQC sought the views of a range of people involved in shaping and leading the system and those responsible for directly delivering care, as well as people who use services, their families and carers.

Reviewers found that there was a good voluntary, community and social enterprise sector in Leeds with many opportunities for people to receive support, particularly for people at risk of social isolation and loneliness.

The review found that when older people attended hospital, there was a higher chance than the England average that they would be admitted, and once people were admitted it was difficult for them to return home with support. The review team also found that some people had poor experiences when they were in hospital.

The report concludes that system leaders in Leeds had a shared vision that was supported and understood across health and social care organisations, with a shared understanding of the challenges ahead (Source: CQC)

The full report is available from CQC

Local system review: Leeds 

NHS safety culture and the need for transformation

Opening the door to change: NHS safety culture and the need for transformation | The Care Quality Commission  

This report examines the underlying issues in NHS trusts that contribute to the occurrence of Never Events and the learning that can be applied to wider safety issues. Never Events are incidents with the potential to cause serious patient harm or death that are wholly preventable if national guidance or safety recommendations are followed.

door to change
Image source: http://www.cqc.org.uk

The review sought to answer 4 questions:

  • How do trusts regard existing guidance to prevent Never Events?
  • How effectively do trusts use safety guidance?
  • How do other system partners support the implementation of safety guidance?
  • What can we learn from other industries?

The report finds that too many people are suffering unnecessary harm because NHS staff are not supported by sufficient training, and because the complexity of the current patient safety system makes it difficult for staff to ensure that safety is an integral part of everything they do.

Full report: Opening the door to change: NHS safety culture and the need for transformation