Half of hospitals and care homes fail to offer proper treatment, says watchdog

Inadequacies in England’s NHS hospitals and care homes highlighted by Care Quality Commission

Many NHS hospitals and care homes in England are failing to give patients safe and effective treatment, protect their dignity, and ensure they eat properly, the health and social care watchdog has said.

The Care Quality Commission (CQC) highlighted a series of inadequacies in the quality of care and treatment provided by large numbers of NHS and independent operators. The regulator found, for example, that almost half of England’s NHS hospitals and care homes that provide nursing failed to meet required standards because they did not give patients safe and effective treatment.

While praising the NHS’s recent progress on improving hygiene, tackling superbugs and eliminating mixed-sex wards, the CQC’s annual report for 2010-11 also identified failings in key areas of performance by state and non-state providers of health and social care services.

Its findings led to calls for immediate action to improve the experience of millions of patients in NHS and private hospitals, residents of care homes and recipients of social care services.

Age UK’s charity director, Michelle Mitchell, said it was “not acceptable that NHS hospitals and care homes are not complying with basic minimum standards, required for the wellbeing and welfare of older people. It’s shocking to see that only half of NHS hospitals and care homes with nursing are meeting their obligations to provide effective, safe and appropriate treatment which meets their needs and protects their rights and that 30% fail on nutrition, welfare and safety.”

The regulator said that 51% of NHS hospitals and the same proportion of care homes met its standard on care and welfare, while 72% of NHS hospitals and 69% of care homes complied with the CQC’s expectations on managing risk to health, welfare and safety. It found that 25% of NHS hospitals and 31% of care homes were not up to standard for the safety and suitability of their premises.

In addition, 38% of NHS hospitals and 39% of care homes with nursing were found to be sub-standard on the management of medicines, while 28% of the former and 29% of the latter were failing to meet people’s nutritional needs.

NHS statistics show that waiting times for patients admitted to hospital suffered a “slight deterioration in the first few months of 2011”.

Simon Burns, the health minister, said the report showed too many parts of the NHS were providing inadequate care. “This report is further evidence of the need to modernise the NHS,” he said. “Despite improvements in some areas, too many NHS hospitals and social care providers are not complying with CQC standards on safe, dignified and effective care. We can, and must, do better.”

Dr Peter Carter, leader of the UK’s 400,000 nurses, said “there are signs within this report which give cause for concern, especially in how quickly waiting times can start to rise when services feel the pinch. The NHS has come a long way from the days of long waits for surgery, treatment and admissions, and it would be a tragedy if this progress was lost.”

Carter also warned of a potential “perfect storm” hitting NHS patient care as a result of tighter , growing demand for healthcare budgets and reorganisation of the service in England.

Jo Webber, deputy director of policy at the NHS Confederation, which represents 95% of the NHS’s employers, welcomed the CQC’s acknowledgement of progress on issues such as cleanliness and infection control. The CQC’s chair, Dame Jo Williams, said that the large number of hospitals they found to be missing key targets was partly due to the limited number of compliance reviews the watchdog had undertaken.

The waiting game

The number of patients waiting more than 18 weeks for treatment in NHS hospitals has risen by over a third, according to the latest figures published by the Department of Health. In July, 28,117 patients, or 10% of the total, had waited longer compared with 20,906, or 7%, the previous July.

Under the terms of the NHS constitution, patients are guaranteed to receive treatment within 18 weeks of referral by their GP, a target recently reaffirmed by David Cameron during the progression of the government’s NHS reforms.

At the same time, the total number of procedures carried out fell from 298,000 to 282,000, which is likely to explained by tightening budgets.

Average wait times fell slightly from 8.3 weeks a year ago to 8.2 weeks.

The Care Quality Commission (CQC), which regulates the NHS in England, acknowledged that waiting times were rising.

In its State of Care overview for 2010-11 it said: “Following a long period of stability, there was a slight deterioration in the first few months of 2011 for patients admitted to NHS hospitals. For outpatients, waiting times remained steady.”

Jo Webber, deputy director of policy at the NHS Confederation which represents hospitals, said: “The CQC highlights the growing tension among NHS trusts to keep waiting times low in the face of rising financial constraints. NHS leaders will have to make some difficult decisions about how care is planned and delivered if we are to avoid a deterioration in the standard of services and patient access to care.”

The government insisted average waiting times remained low and stable. The health minister Simon Burns said: “The vast majority of patients receive treatment within 18 weeks.”