1 17/10/2017 Variation between Mental Health Trusts Wexham Park - PDF document

17/10/2017 Where have we come from? 2009 • CQC was established, bringing together 3 organisations: HCC, MHAC, CSCI • Generic model of inspection, with inspectors expected to cover care homes, GPs, dental practices, hospitals, mental health etc. • Mental Health Act work carried out in isolation from other inspections 2013 Keeping quality at the heart of patient experience • September 19 th 2017, Guildhall, London Francis Report on Mid Staffordshire, February 2013 • Concerns that other problems had not been uncovered (e.g. Winterbourne View; Morecambe Bay) • Keogh reviews of 14 trusts with high mortality • “Raising standards, putting people first” CQC Strategy May 2013 • “A new start” consultation June 2013 • CQC appoints 3 chief inspectors • Wave 1 inspections for 18 acute hospitals 2 Where have we come from? Current Ratings: NHS Trusts 2014 N I RI G O • Hospitals Directorate established Acute 136 7% 57% 32% 4% • Comprehensive inspection programme rolled out across acute, mental Specialist 18 - 28% 44% 28% health and community health trusts Ambulance 10 20% 40% 30% 10% Community 18 - 44% 56% - 2016/17 Mental Health 55 - 58% 38% 4% • All trusts and independent sector providers inspected • MHA incorporated into operational teams Overall 238 5% 54% 36% 5% • Good overview of services that can inform wider policy • Methodology being refreshed 3 4 Current Ratings: Independent Variation between Acute trusts/locations Sectors Frimley Park NHS Foundation Trust 2014 Wexham Park Hospital 2014 N I RI G O Acute hospitals 113 1% 29% 65% 4% Single speciality 2 50% 50% Community 3 67% 33% Mental Health 205 4% 26% 66% 3% Overall 323 4% 26% 66% 3% 5 6 1

17/10/2017 Variation between Mental Health Trusts Wexham Park Hospital East London NHS Trust 2016 Norfolk & Suffolk NHS FT 2014 2014 2015 Safe Effective Caring Responsive Well-led Overall Safe Effective Caring Responsive Well-led Overall Adult acute wards & Requires Acute wards for adults of Inadequate Good Inadequate Inadequate Inadequate PICU's Improvement working age and psychiatric Good Good Outstanding Outstanding Outstanding Outstanding intensive care units (PICU's) Safe Effective Caring Responsive Well-led Overall Adult long stay / Long stay/rehabilitation Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable rehabilitation wards mental health wards for Good Good Good Good Good Good Urgent and working age adults Forensic inpatient / Requires Requires Requires Good Good Good Outstanding Outstanding Outstanding Inadequate Inadequate Inadequate emergency services secure wards Improvement Improvement Improvement Forensic inpatient / secure Requires Good Outstanding Good Good Good wards Improvement Medical care Requires CAMHS Good Good Good Good Good (including older Good Good Good Good Good Good Improvement Child and adolescent mental people's care) Good Good Outstanding Good Outstanding Outstanding health wards Requires Requires Requires Requires Wards for older people Good Inadequate Surgery Good Good Good Good Outstanding Good Improvement Improvement Improvement Improvement Wards for older people with Good Good Outstanding Outstanding Outstanding Outstanding mental health problems Wards for people with a Requires Requires Critical Care learning disability or Inadequate Good Inadequate Inadequate Good Good Outstanding Good Outstanding Outstanding Wards for people with a Requires Improvement Improvement autism Good Good Good Good Good learning disability or autism Improvement Maternity and Good Good Good Good Good Good Adult community-based Requires Requires Requires Requires Gynaecology Community-based mental Good Inadequate services Improvement Improvement Improvement Improvement health services for adults of Good Good Good Good Outstanding Good Services for children working age Good Good Good Good Good Good Community-based crisis Requires Requires Requires Requires and young people Good Inadequate Mental health crisis services services & HBPoS Improvement Improvement Improvement Improvement and health based places of Good Good Good Outstanding Good Good End of life care Good Good Good Good Good Good safety Specialist community- Requires Requires Requires Requires Requires Specialist community based services for Good Improvement Improvement Improvement Improvement Improvement Outpatients and mental health services for Good Good Outstanding Outstanding Good Outstanding children & young people Inspected but Good Good Good Good Good children and young people Diagnostic Imaging not rated Community-based Requires Requires Requires Community-based mental Requires Good Good Inadequate services for older people Improvement Improvement Improvement health services for older Good Good Outstanding Outstanding Good Improvement people Overall Good Good Good Good Outstanding Good Community-based Community mental health services for people with Good Good Good Good Good Good services for people with a Good Good Good Good Good Good a learning disability or learning disability or autism autism Requires Requires Overall Good Good Outstanding Outstanding Outstanding Outstanding Overall Inadequate Good Inadequate Inadequate Improvement Improvement 7 Impact of our inspections on quality Calderstones Partnership NHS FT and safety • We know that providers make improvements before our inspections – but difficult to quantify Calderstones Partnership NHS Foundation Trust Calderstones Partnership NHS Foundation Trust 2014 (shadow ratings not published) 2015 • We observe improvements when we raise immediate concerns Safe Effective Caring Responsive Well-led Overall Safe Effective Caring Responsive Well-led Overall during an inspection Forensic inpatient / Requires Requires Requires Requires Forensic inpatient / Inadequate Good Good Good Good Good Good Good • secure wards Improvement Improvement Improvement Improvement secure wards We observe changes in response to enforcement action Community-based Community-based • services for people Requires Requires Requires Requires services for people Requires Inadequate Good Good Good Good Good Good The provider survey tells us that our inspections are helpful in with a learning Improvement Improvement Improvement Improvement with a learning Improvement disability or autism disability or autism identifying areas for improvement Requires Requires • Overall Inadequate Inadequate Good Inadequate Overall Good Good Good Good Good Good Improvement Improvement Ultimately: We reinspect to assess change over time 9 10 NHS trust inspections – Our next phase of regulation what we are proposing to change Changes to KLOEs and “ A more targeted, responsive and collaborative inspection methodology approach” • Focus our inspections where we have the greatest concerns or Strategic objectives services that might have improved • Encouraging improvement among providers • Develop our local relationships with providers, with Healthwatch • Intelligence driven inspections and local and regional public organisations • Developing a shared view of quality • Accommodate new models of care • CQC becoming more efficient • Align our approach with NHS Improvement to avoid duplication 11 2