Hospitals to be given Ofsted-style ratings...

[dutchman]

Hospitals will be told to make urgent improvements if any department is providing poor care, under new Ofsted-style ratings prompted by the Mid Staffordshire NHS scandal.

The "tough and rigorous" ratings will go further than Ofsted's single overall ranking for schools in England by giving an official assessment, from "inadequate to "outstanding", based on inspections of every department of every hospital.

The Care Quality Commission (CQC), which regulates NHS care, hopes the ratings will drive up standards and give patients and families a better insight into the quality of treatment they can expect from particular hospital services.

Under CQC plans being unveiled on Monday, inspectors will rate every department, as well as each hospital and hospital trust, as inadequate, requires improvement, good or outstanding. The changes will begin in October, with the first ratings published in December.

The switch from the CQC's widely discredited hospital monitoring system was ordered by the health secretary, Jeremy Hunt, in the wake of Robert Francis QC's report in February into events at Stafford hospital, where between 400 and 1,200 patients died unnecessarily as a result of poor care and neglect from 2005-2008.

Inspectors will examine if the care is safe, effective, caring and compassionate, well-led and responsive to patients' needs, and decide on a rating for each. They will examine if staff have breached any of 10 new "fundamental standards" of care, as suggested by Francis.

Failings such as dementia patients being isolated in their rooms all day and not receiving support and stimulation, would be classed as a breach of the fundamental standards. Lapses such as a patient going thirsty because his or her water jug has not been filled, or hungry because staff have not helped with eating, would not necessarily on their own count as a breach, unless they were found to happen regularly or across a number of departments.

[rebbonk]

When will they learn? Measures drive behaviours; all that will happen is that actions will be taken to get good ratings, and that might not necessarily benefit the patients as it's intended to.

For example, at the moment 4 hours is the first critical measure in A&E. If you are not seen within 4 hours, the next measure kicks in at 12 hours. Hence those waiting 3 hours 50 minutes are higher priority than those that have been waiting 6 hours; the former may still beat the 4 hour measure, but the latter have already missed the first measure, and are still a long way clear of the second measure.