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SEP 20/2014

How CQC Special Measures Prompt Hospital Improvements

One of the most important ways of ensuring hospital doctors and nurses are able to work to their maximum potential is to put a system of strong regulations in place to get the best out of staff.

In the last few months, healthcare sector regulator the Care Quality Commission (CQC) has been working to drive up standards among NHS hospitals with a new special measures regime. This system has made it easier for failing hospitals to address their problems and devise a structured plan to correct them.

As a direct result of this new system, the standard of care at a number of facilities across the country has been turned around with enough success that plans are now afoot to extend this regulatory model to other key NHS sectors.

How special measures have helped hospitals
Special measures is a new regime for NHS trusts and foundation trusts that have been found to have serious failings in their quality of care, as well as prevailing concerns that the existing management cannot make the necessary improvements without support.

Following this, the CQC - in partnership with Monitor and the NHS Trust Development Authority - provides a 12-month package of support, including assessments of board capacity and capability or the appointment of an improvement director to support the turnaround - in order to ensure the hospitals are able to bring their performance up to the required level.

Introduced in the wake of Sir Robert Francis's report into failings at the Mid-Staffordshire NHS Foundation Trust last year, the new system initially saw a total of 11 trusts placed into the new special measures regime in July 2013.

A progress update from earlier this month has revealed that in the 12 months since, significant improvements for patients have been observed at ten out of the 11 trusts, with managers and clinicians alike having pulled together to identify the problems and address them proactively.

Trusts that took ownership of the challenges and enacted early action tended to see the most improvements. Recruiting extra staff, introducing better systems to manage patient flow, better handling of patients with life-threatening conditions and a renewed emphasis on quality of care have all helped.

Two trusts - Basildon and Thurrock University Hospitals NHS Foundation Trust and George Eliot Hospital NHS Trust - have now attained a rating of 'good' overall, while Buckinghamshire Healthcare NHS Trust, East Lancashire Hospitals NHS Trust and Northern Lincolnshire and Goole NHS Foundation Trust have all been classified upgraded to the 'requires improvement' category. All of them have been taken out of special measures.

GPs and social care - the next step
In the coming months, the CQC will be expanding the remit of the special measures regime to encompass even more of the NHS. It is currently in the process of working with the adult social care sector to develop a new regime to tackle failures in social care provision through special measures from April 2015.

Similarly, a special measures system for general practice is also being devised and will be introduced from October 2014 onwards. The CQC will soon begin rating 8,000 NHS GP practices to identify which surgeries are most in need of special support.

This will bring these sectors in line with others regulated by the CQC and will hopefully ensure the recent improvements seen in hospitals can be extended across the entire NHS.

Professor Steve Field, the CQC's chief inspector of general practice, said: "When health and care organisations fail the people to whom they provide care, it's important that failure is identified quickly and the action is to ensure services for people improve. That sits at the heart of special measures."

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