I think the HSJ's Sarah Calkin has written the most important article of the year.  It is about the CQC.  Regular readers will know I don't have any time for the CQC.  Not the people at their coal-face; I know they come to work trying to do the right thing.   

It is the whole concept of inspection that is so outmoded and cack-handed that drives me around the bend.  The political deception that cons the public into believing inspection makes a difference irritates me plus the senior people at the CQC, many with MBAs and MSc's who know perfectly well I am right, yet they persist, aggravates me beyond belief.

When NHS inspection failed to improve anything they decided to do more inspecting.  When that was not producing results we were asked to believe that more intense inspections were called for.  In a final flourish that would have killed off any other inspection regime, the CQC with no hint of irony or humility, blithely announced that after 14 years of inspection, patients were still at risk in a quarter of hospitals.  Wake up; inspection don't work.

Being useless is one thing.  Being useless, knowing it and keep on doing it is a special kind of madness.  Henry Ford, Einstein, Anthony Robbins who ever said it was right; 'keep doing what yer doin' and you'll keep getting the same'.

Dislodging the CQC from the bastions of the NHS establishment will take time but they will go.  Logic, management theory, funding and results are on my side.  However, I think Sarah Calkin might have hastened the day. 

She has discovered; "Patients and the public have not been told about hundreds of serious concerns about health and social care services uncovered by the Care Quality Commission... " It turns out the CQC does not press release a quarter of serious concerns.

Using FoI Calkin revealed that almost a quarter of the 2,729 warning notices issued by the regulator in the past two and a half years have not been made public. 

Looking at their accounts, it seems the CQC spend something north of �60m pa.  I have no idea how much Deep Diver will add to the costs.  I guess we'll find that out eventually.

Working on just �60m: over two and a half years that adds up to �150m to keep them in business; in that time 2,729 warning notices have been issued.  I make the cost of each one to be about �55k each. 

A lawyer specialising in defending providers, interviewed by Calkin, said in some cases failings may have been rectified almost immediately, so publicising a warning notice could create 'unnecessary concern' among the public.  He added; "...publication creates a stigma for the particular service..." 

It also emerged the non-publication policy meant, when requested by HSJ; "...the CQC was unable to provide details of all the NHS locations that had been issued with a warning notice."  Read that again!  Yes, it's true!

At the bottom of the HSJ article you'll find readers' comments including a very interesting one claiming the CQC tipped off a Trust before an unannounced inspection.  I have been told tip-offs are common and I know, from my post-bag, the lengths staff are obliged to go to, to prepare for the CQC.  It takes days, costs thousands and by the looks of it breeds lawyers.

So, let me see if I have this right.  We are paying the equivalent of a year's wages for a couple of nurses to find 'trivial' things that have gone wrong and the CQC can't remember where they were.

Put it all together and we have; unannounced visits that are announced, �55k+ for warnings about stuff, one in four of which is trivial and in places they can't remember.  Lawyers getting in the way of telling local people what is going on in local services and after 14 years of inspecting, a quarter of all Trusts are still too risky for patients.  The coup-de-gr�ce; we are giving the CQC more money to do more of it.

Sarah; nhsManagers.net don't do awards but if we did you would be the journalist of the year!