22nd August 2016

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Ed Smith
Chair of Not-Monitor, or whatever it's called.  In conversation with Roy L
Good conversation, networking and a glass of wine.  What's not to like!  This will be a full house.  
If you are intending to come, get your tickets organised!.
News and Comment from Roy Lilley
I am exasperated.  I have no idea how much longer Ministers will allow this to go on.
Increasingly, commentators and players in the health space have pointed out that the fortunes of the CQC are going from bad to worse.
Now, they've done it again... twice in one week.  That takes talent!
First; they've found themselves in a row with GPs that has ended with them, entirely predictably, on the wrong side of a court action.
In every supervisory regime from government to the darts club committee, it is accepted that they may get something wrong and should create a transparent appeals process.  You might call it natural justice.
The CQC has no such processes and relies upon judicial review as the remedy for complainants.  European Court decisions tell us this is unsatisfactory.  NICE has a transparent appeals process; hence they largely avoid the courts.
Despite having a 'public duty to be fair' almost nothing the CQC does can be challenged.  In 2014 they said they would create an appeals escalation process but appear not to have done so.  Last week they came unstuck.
The court told the CQC to appoint an independent expert to review GP practices' requests for factual corrections before publishing their inspection report, rather than leaving it solely to the lead inspector.  You must read this comprehensive coverage from Pulse and the comments from GPs.
How much has that little excursion to court cost the taxpayer?  

If anyone would like to do an FoI on what the CQC forks out in legal fees, we will be delighted to publish it.
Next came a row with Marie Stopes; internationally famous for their work in birth control.
Stopes' CQC ratings, in the last nine months, have gone from 5 green ticks, to services for vulnerable young women closed down because they are 'dangerous'.  Without a by-your-leave over 200 women a week, mostly under 18yrs, will be left to try elsewhere for help. 
A termination must be harrowing enough; laden with moral and ethical dimensions as well as clinical and relationship issues.  Thanks to the CQC they have even more to worry about.  NHSE are in a flap trying to provide alternative services.
The CQC website comment is here.  It seems we are to wait until the Autumn before they can publish a report?  Why?  This is a matter of urgent public concern.  The CQC say they are concerned that;

 "... the right protocols may not be in place to ensure that girls under the age of 18 were able to give informed consent to a termination."
Note the 'may not'.  Does that mean maybe they are? 
They were also concerned about the standards of anaesthesia in clinics, in a small minority of cases, when women were undergoing surgical abortion after 12 weeks of pregnancy; 

"... a lack of assurance in relation to training and competence in conscious sedation and general anaesthesia..." claimed the CQC.
As concerning as these issues may be, it cannot be beyond the wit-of-man to fix them... if they really do need fixing... in short order.  Closure of services?  Really?
Marie Stopes said; 

"...the organisation was slightly surprised by the timing and tone of the announcement. This was about governance and protocols and there was nothing that endangered the safety of its clients."

'Slightly surprised'?  I bet they are!  I bet they'd like to appeal... but they can't.
No one can challenge CQC reports, their bias or otherwise, their accuracy, skills and experience of inspectors or expose an axe-grinder at work.  No one holds the CQC to account.
Daily, I get CQC stories.  Bullying, ignorance, inconsistency, rudeness, incompetence, delays... along with insights from inspectors past and present. 
And, from very senior NHS bosses who tell me of their frustration but are terrified of reprisals if they are associated with a complaint about the CQC and the absence of a transparent, accountable appeals process.
In the CQC's own confession only 6 out of 21 Trusts, re-inspected, have shown improvement.  That is because inspection has nothing to do with quality.
It is long past the time for ministers to say; 

'... the CQC were set up years ago when all we could do was to turn up with a clip board, inspect and report retrospectively.  Things have moved on.  Today we can use technology to answer the timely and vital question; 'how good were we today'.  That's what we need to know...
The CQC is an anachronism, is looks to be achingly badly run, with more than a whiff of institutional arrogance about it. 
It's time for ministers to act 
It's time for Trusts and GPs to withdraw cooperation
It's time for Trust Boards to speak with their local MPs about making changes...

... and it's time to end this farce. 
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26th Sept Kings Fund  5.30pm.
Ed Smith 
Chair of Not-Monitor 
(I must find out what they are called!)
Great evening in prospect.  He has a huge experience and a raconteur 
Plus the usual wine and networking. 
Tickets here
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - trouble at Moorfields as they restructure.  Staff very upset that they have to reapply for their jobs.  Wouldn't a pre-screen for incumbents have been more sensible?  I'm hearing there is a whiff of bullying about the place?.  Apparently key staff are leaving.
>>  I'm hearing - there is a survey doing the rounds, focusing on Capita's PCS performance and the results are horrendous.  Why doesn't NHSE get a grip of this?
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