Routine inspections of hospitals and other health and care providers should be paused until after winter if providers are to be able to focus on the backlog of treatment that has built up in recent months, as well as address issues like exhaustion among staff, while managing the ongoing threat from coronavirus.
That is the call from the NHS Confederation in a letter today to Secretary of State for Health and Social Care Matt Hancock
. The health secretary recently outlined his vision for “busting bureaucracy” and health leaders now want to see this backed up with a major shift towards a lighter-touch and more agile system of regulation over the longer term.
In the latest report from its NHS Reset campaign
, the NHS Confederation calls for a continuation of the lighter-touch approach to governance and regulation that has been a feature of COVID-19
. NHS leaders say this has enabled them to focus on delivering care to patients and to work more efficiently, with less interference from national bodies and reduced requirements for meetings and paperwork that add little to patient care. They want to see the lessons from the pandemic embedded and do not want to return to the pre-COVID approach to governance and regulation.
Health leaders know scrutiny is vital, given how critical patient safety is to the delivery of health services – and the NHS Confederation believes there will be broad support for comments made earlier this week by Ian Trenholm, chief executive of the Care Quality Commission, which outline the regulator’s desire to reduce the burden on providers.
But they believe the Government will need to go further and take this opportunity to review the regulatory burden placed on providers from NHS England and NHS Improvement and other national bodies, as well as the CQC.
Danny Mortimer, deputy chief executive of the NHS Confederation, said: “Healthcare needs regulation and oversight, but NHS leaders want to see a radical shift away from the excessive paperwork and other reporting requirements that have become an industry in recent years. All too often, these only serve to provide false reassurance, rather than enhancing patient safety. The experience of COVID-19 has shown what can be achieved when we have a lighter touch approach in place.
“The health secretary was right to identify this as an area in need of reform. But successive governments have promised to cut red tape while actually presiding over and instigating an expansion in the bureaucratic burden on providers. In the immediate term, we need to put this in reverse and suspend routine inspections until after winter, when the lessons from the pandemic can be put into practice.
“Ultimately, we need a more risk-based, proportionate and intelligence-driven approach to regulation that fosters innovation and does not weigh providers down with reporting requirements that take them away from delivering high quality care to patients.”
The NHS Confederation makes a number of other recommendations for national bodies, such as:
Make regulation proportionate and risk-based – Our members accept the need for regulation and accountability, but we will fail patients if we fail to build on the light and agile governance and regulatory structure of the pandemic.
Align and integrate regulation and performance management – Duplication must be reduced at NHS England and NHS Improvement regional level in the short term and a review is needed of the performance and assurance roles of clinical commissioning groups, NHS England and NHS Improvement regional teams, and professional and safety regulators in order to streamline reporting arrangements.
Reset the regulatory architecture towards system working and integration – COVID has taught us that integration works. The CQC needs support to recalibrate the inspection regime towards systems and patient pathways, and will struggle without legislation to reflect the realities of system working and the new health and care landscape.
Maximise the integration of digital technology through increased funding – Digital inspection and reporting methods should be increasingly used, and our members need effective digital infrastructure. The Government must take ownership of this; the current commitment of £4.7 billion in the Digital Transformation Portfolio is not sufficient to transform services and therefore simplify governance and regulatory work.
The report also sets out how local NHS organisations are ready and willing to take on some of the responsibility for reducing bureaucracy themselves. To embed the transformation brought about by the pandemic, they are keen to encourage leaner and lighter governance structures, with fewer committees and shorter and simpler board reporting.