Sometimes writing comes easy. Sometimes it sticks a bit. There are days, even in the wacky world of the NHS that ideas are thin on the ground, or repetitive.
Sometimes events just defy explanation, or get too complicated. Today is one of the days that just defy gravity, common sense, the laws of physics and polite society.
This document appeared in my inbox. I don't know where it came from or if I'm supposed to have it. I understand it came from the CQC. A graph and a couple of spread sheets. If I have read it right it is their thinking on how they are going to make up for the fact that the Treasury don't regard them as part of the NHS and cannot be the beneficiaries of ring fenced funding.
The Treasury think the CQC should recover their operating costs by charging full recovery fees (HSJ story here) from the organisations they inspect and license to provide NHS services.
That means care homes who have had their fees slashed by local government will have to stump up, hospitals (most of whom are running into a debt crisis) will have to pay up and GPS who are seeing 93% of first contacts for a diminishing 8% of the NHS budget will have to fork out.
The proposed increases in fees are reaching a whacking hike of over 300%.
As the rest of the NHS faces austerity with reorganisation, cut backs, redundancies, innovation and working smarter, from these papers it would appear the CQCs best answer is to put its prices up. No cuts, trimming or shaving at the commodious CQC. They are consulting on this topic right now.
The CQC has become a Billy No Mates, feral organisation. Save for an annual report and the odd appearance in front of a gullible select committee, unaccountable. With what I regard as one of the poorest Boards in the public services the CQC takes half a life time to deliver out of date reports that must cost about �300k a hospital.
After 16 years of inspections of all types and flavours, our hospitals and care homes are not safer, old people dumped on the pavements and the public, who let's face it, have no choice, still have to use 'unsafe' hospitals. In fact this OECD report casts a dark shadow right across NHS safety. Summary here.
There is no detectable return on the public's investment in an inspection model to ensure the quality of health and care services. Neither, for that matter does it appear to me inspection improves schools.
The CQCs work is not benchmarked, compared, measured or calibrated. They work to no international standards I can find. Their observations are largely anecdotal, unchallengeable and repetitive. Standards they have largely made up. The predictable report;
'There are not enough nurses therefore this Trust in unsafe, badly led and blah, blah...'
It takes integrity for an organisation, in this predicament, to go to ministers and say; we can't deliver what you want... even without the cuts in budget.
It would take courage from ministers to recognise that inspection, if it ever had a place in healthcare, was an idea for the 1980's.
I have spent a couple of days in the future; at the fabulous EHI Live event in Birmingham. A cornucopia of innovation based on software algorithms, data analysis and kit and caboodle to make us safer, more effective and efficient. Plus the new My NHS web-site - beta version here.
Real time analysis of care providers' performance is a reality. Turning up with 150, of what I am repeatedly told are, poorly trained, bewildered inspectors, trampling through a Trust or care home belongs in the era of flared trousers, flowered shirts and Dennis Waterman's 'Minder'.
We can know, right now, how many staff are on a ward, what the real-time trips, slips and falls data is. We can tell, today about vital signs trends, treatment outcomes and infection rates. We can know who ate what and when, who was prescribed what and what for and did it work.
The CQC makes bus companies and hoteliers richer and plans to make the NHS poorer.
Enuf is Enuf!
