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Costly CQC acute trust inspections not associated with improvement, study finds


By Valeria Fiore
Reporter
15 April 2019

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Expensive CQC inspections are not associated with improvements in the quality of care, a study has claimed.

Researchers from the University of York and Leeds calculated that one CQC inspection costs a hospital between £169,000 and £420,000 according to its size and the preparation required.

However, the researchers revealed in a study published in the Journal of Health Services Research and Policy that the costly CQC interventions are not conducive to the improvement of rates of falls resulting in harm and pressure ulcers following treatment in acute trusts.

The researchers are calling for less ‘resource-intensive inspections’ and are asking the CQC to rethink its approach to its inspection regime.

The study

The researchers analysed the impact of CQC inspections in 150 NHS acute trusts between April 2012 and June 2016.

They focused on monthly data on falls with harm and pressure ulcers, looking at how the rates for both were changing according to two different types of CQC inspections – one that demanded greater input from staff and long visits and a less ‘resource-intensive approach’.

Neither of these systems was associated with improvement in rates of falls or treatment of pressure ulcers, the researchers concluded.

They compared these results with trusts that had not been inspected in that same period and found that the rate of improvement of the trusts inspected by the CQC ‘was worse compared to those trusts that did not get inspected’.

‘Pressure on staff’ and costs

Lead author of the study Dr Ana Cristina Castro said a ‘less resource-intensive approach’ is needed to allow staff to focus on long-term improvement.

She said: ‘Since 2013, CQC inspection teams regularly visit NHS trusts over several days, with more than 150 inspection measures, and rate them against legally enforceable standards of care.

‘This creates a significant pressure on staff before and during the inspection period, and also significant costs, not just of the CQC inspectors but also the NHS staff who are diverted from other activities.’

The CQC should reduce the administrative burden that comes with every inspection, the researchers added.

University of York’s Department of Health Sciences professor Trevor Sheldon invited the CQC to ‘rethink their approach’.

He said: ‘Health service and government leaders need to focus less on the methods of monitoring and more on promoting and supporting the many efforts that already exist nationally and within trusts to improve quality.’

However, a CQC spokesperson said the research represents an ‘overly simplistic view’ of the quality of inspections carried out by the CQC.

The spokesperson added: ‘This research is based on limited sample of inspections undertaken over five years ago at the start of our comprehensive inspection programme – which initially focused on high risk trusts such as those placed into special measures following a review by Sir Bruce Keogh.

‘Since that time we have refined and strengthened our inspection methodology, moving towards a more intelligence driven approach. We continue to see the positive impact of regulation in driving improvements in care, with many hospitals able to improve their rating on reinspection. As a result, patients across England are receiving better and safer care.’

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