11th December 2013 

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Conference Special - Brian Jarman in conversation with Roy on data, HSMRs,  
what's safe and what's not.  Owing to demand we'll move to a bigger room..  
  London 22nd Jan 2014  More details here.

News and Comment from Roy Lilley

I thought I'd see how my local Trust was coping with the extra winter pressures.  I went to the CQC website and searched; 'hospitals', 'A&E Performance' and entered my post code.  This is the answer I got:


Sorry but there were 0 results from our latest checks on Hospitals services for A&E performance in postcode GUXX XXX


I guess they don't know about the four hospitals within 20 minutes of where I live?  So, I went to the BBC Website; I put in my postcode.  They knew all about #fabulousfrimleypark and told me exactly how it's doing.  Wow!  Check out your postcode!


I wrote about the CQC twice last week and my in-box exploded.  The emails are universally unflattering for the CQC bosses.  Emails from CQC staff, the NHS front-line, practices, the Board Room all in confidence so it is difficult for me to know what to do.  However, I have persuaded one writer to let me anonymise and reproduce their exchange with the CQC.  It's priceless:     


"Recently I wrote this to the CQC:


How do you know when the CQC inspectors come to visit? 

Staffing levels have been DOUBLED for just that day... normally the place scrapes by on half of that providing woefully inadequate care... and that the managers don't ON ANY OTHER OCCASION make beds or bring biscuits for the staff!  There must be some perverse financial incentive for this charade. Why doesn't everyone throw their hands up and say 'help' instead of pretending everything is lovely and tidy.  I don't want to identify myself. I don't want to lose my job. I just wish you'd turn up unannounced and see the real chaos.


The CQC wrote back with a standard letter which ended in:


Please note that should we not hear back from you within the next 7 working days, we'll assume that you no longer require our assistance. Should this not be the case, we'd request that you resubmit your original email detailing these concerns plus the important details we've requested above, and we'll be happy to assist you.


My correspondent finished their note to me with:


... and this last bit gave me all the assurance I needed that they actually gave a toss!"


No large organisation can get it right all the time.  In the best of well-run organisations things go wrong but it is the measure of that organisation how well and quickly things are put right.  It is also true to say that people who chose to write to me are self-selecting and may have an axe to grind.  


However, common-sense tells me the volume of complaints I get must mean something.  The shared themes must be an indicator?  The crescendo of voices, often from very senior people in Trusts and the chorus from the front-line tells me the CQC is holed beneath the water line.


Inspection is an outmoded concept; does more harm than good, deceives the public and demotivates staff.  The CQC turns nervous managers into, at best, pantomime directors and at worst, deceivers.  But, it makes coach drivers rich; 130 inspectors turned up at the Barking, Havering and Redbridge Trust this week. 


It's time for some CQC honesty.  They cannot do what is asked of them.  They cannot keep us safe, they cannot guarantee our care, they cannot deliver an efficient system.  They know they can't, they've had 14 years of trying and they admitted 25% of Trusts are not safe.  Goodness knows what is happening behind the closed doors of care homes.  Every day I cross my fingers that there won't be another story of unspeakable cruelty.


Half in jest I've already suggested we axe the CQC and replace them with the National Academy for Fabulous Stuff.  The NAFS, hunting down what's works and strong...  not what doesn't and wrong.  Now I'm serious. Keep inspecting, keep finding things wrong, keep doing the same things... doesn't keep us safe.  Root cause analysis is beyond the ken of the CQC, politicians, the DH, the Carbuncle and the TDA.


Change from blame and shame... to asset based development.  Build on the asset skills of staff, the power of professionals and the support of institutions and community.  Instead of stalking everything that is wrong, search-out and share strengths and successes to build stronger, sustainable services.


The CQC is divisive when we know we are better together.  The CQC is destructive when we know we are at our best when we build.  The CQC looks for failure when we are desperate to seek out success.  The CQC turns good people into liars when we need them to tell the truth.


When I have to turn to the BBC to tell me about the performance of my local hospital because the CQC can't, I know its it's time for them to fess-up.

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