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Slumping productivity hits CQC inspection regime

The CQC has failed to increase its rate of inspection of adult social care, hospital and primary medical services, despite a recent focus on this critical shortfall.

In a board paper to be presented at its meeting on Wednesday (18 November), the inspection body revealed that progress during the second quarter of 2015-16 had plateaued. September’s inspection figures across the sectors showed little change on the previous months – when in fact inspection rates need to rise rapidly to deal with the shortfall and hit targets.

The organisation had already indicated back in September that it would not be able to recover its performance levels if it continued to fall behind inspection targets and productivity failed to improve quickly.

But in October, its situation had remained largely stagnant, with all directorates within its inspection regime slumping behind targets. By then, the CQC had admitted it could not guarantee it would deliver its planned programme by 2016-17.

Shortly after, its managers were grilled by MPs in a Public Accounts Committee inquiry that analysed how the body was responding to the string of new responsibility it has been given throughout the year.

In this quarter, similarly to quarter prior, adult social care inspections only covered 70% of the intended programme, while primary medical service inspections looked at 61% of what was originally intended.

The CQC was supposed to have inspected all social care and GPs and out of hours services by 30 September.

A report to the board said: “There are a number of factors that have contributed to this. In summary, this includes the time it has taken to both recruit the required numbers of inspectors and to ensure they are fully trained to conduct inspections; and the lower than expected level of productivity required as all inspectors get up to ‘full speed’.

“There has also been a lag in some new systems and tools to support inspectors in delivering our new approach, such as the introduction of the new ASC inspection webform in September to accommodate the implementation of a new end to end inspection process.

As reported to the board in October, we are introducing a number of measures to improve productivity as we go into the new financial year.”

But hospital inspections, though only having hit 87% of the planned in-quarter targets, were progressing better as the directorate confirmed it will be able to achieve its first ratings inspections by March 2016 (acute non-specialist trusts) and June 2016 (all remaining NHS sectors) – but further planning is required to help meet the December 2016 commitments.

And inspections of hospital acute, community trusts and ambulance and mental health services were faring better. Hospital acute inspections had achieved 104% of its target, meaning it performed two more inspections that originally intended in the programme to date.

More final reports are also being published within 50 working days, although this only represents 59% of all reports.

But further information included in this month’s board papers showed that even where inspections are made, trusts may be struggling to improve services before a re-inspection.

Only 44% of adult social care providers (171 of 390) delivered services that were improved enough to receive a better rating at their next CQC inspection. For hospitals, this figure was only 25%, with six out of the eight re-inspected receiving the same rating.

But GP practices showed much more improvement post-inspection, with 86% of providers getting an improved rating after re-inspection, and none deteriorating.


Elaine   16/11/2015 at 15:38

Decreasing productivity and increasing over expenditure. Why is this organisation not being subject to the criticisms and improvements that the rest of the NHS has been subject to? No it just trundles on spending and criticising others.

Linda   16/11/2015 at 16:41

Completely agree with Elaine - why are we funding this the increase in fees next year represents a good part of an HCA - I wonder (not) which would actually benefit our patients; more HCA hours or CQC inspection. By all accounts completely in consistent and subject to foibles of lead inspector and anyone who protests is basically told to be quiet. Responsive to needs of users - no useful to patients not on evidence to date.

GR   17/11/2015 at 10:55

CQC - Do as we say not as we do at its best.......

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