Dr Howard Freeman considers the main takeaways from the quality regulator’s latest assessment of independent sector hospitals.
Last week saw the publication of an important report by the health regulator, the Care Quality Commission (CQC), which shone a light on the quality of care in independent sector hospitals. While it found there are some areas where independent hospitals can improve, it made clear that the public should be assured that they deliver overwhelmingly safe and effective care.
Independent hospitals deliver services both to NHS and privately-funded patients and, as the CQC acknowledged, make a very important contribution to delivering healthcare services throughout the country.
While attention focused on some of the areas of improvement that parts of the independent sector need to make, the report also made clear that the sector has a great deal to be proud of – the vast majority of independent acute hospitals are providing high-quality care for both their NHS and private patients, with 70 per cent of hospitals rated as either “good” or “outstanding”.
While direct comparisons are difficult, this compares very favourably to the performance of the wider healthcare system in England and serves to illustrate the fact that the CQC holds all providers of healthcare services in England to a very high standard, something that should reassure patients and the public.
The responsiveness of independent hospitals was highlighted as a particular strength, with patients having prompt access to treatment with very few cancellations or delays. Access to independent hospitals for privately-funded services is rightly excellent but even for NHS-funded services, outpatients that exercise their legal right to choose to be treated by an independent hospital free at the point of us can expect to be seen eight days earlier than the NHS average.
Staff in independent acute hospitals were also singled out for their outstanding work – praised for providing individualised, one-to-one attention as well as excellent continuity of care for patients. High staff morale was highlighted as having a positive impact on patient care, with excellent completion rates for training.
And where concerns were raised by the CQC, it was encouraging to see the regulator emphasise how impressed they were with the ‘rapid action’ taken by several independent providers to improve care.
However, as the Royal College of Surgeons rightly identified in their response to the report, there is no room for complacency and further work will be needed to drive up standards across the sector, including to ensure that those performing less well catch up with the top performers.
One of the areas highlighted by the CQC was the need to ensure that all providers take full corporate responsibility for medical governance and build on the excellent work of a number of operators in holding clinicians to the highest possible standards. Much has changed in recent years in the independent acute sector and huge gains have been made, but it is clear that some operators have work to do to bring the risk of clinical error down to a minimum.
It is also clear that responsibility for overseeing hospital consultants needs to be system-wide, given the fact that clinicians often work across multiple providers, both independent sector and NHS.
There is also a need to ensure that all healthcare providers are open and transparent about the quality of care they deliver and the outcomes they achieve. There should be no reason for independent sector providers not to be confident about this. Scores for primary hip replacement as measured by Patient Reported Outcome Measures shows that 19 of the top 20 providers in England are from the independent acute sector and independent providers have extremely low rates of hospital acquired infections.
Patients’ expectations of healthcare are rightly increasing and it is vital that services in both the independent sector and the NHS maintain a laser-like focus on improving the safety and quality of care for patients. The CQC perform a valuable public service in holding up a mirror to all healthcare providers across the independent, public and voluntary sectors to help them to achieve this and in supporting patients’ make the best choices for them.
Last week’s report will act as a spur for improvement for all those independent providers who know that they have further to go to reach the excellent standards of care to which they aspire. But in doing that the public should be reassured that the overwhelming majority of care delivered in the independent sector is good or outstanding and that everything possible is being done to get all providers to that level.
Dr Howard Freeman is clinical director at the NHS Partners Network, a part of the NHS Confederation. Follow the network on Twitter @nhspartners