Care Quality Commission
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Healthcare watchdog to cross-check NHS performance as trusts make

More trusts have declared that they are compliant with more of the standards compared to last year in first stage of annual performance assessment

The Healthcare Commission today (Monday) said it would carry out a thorough check of NHS trusts’ public declarations on whether they meet the government’s standards for healthcare.

For the third year running, every NHS trust in England has issued a public declaration on how they think they are performing on meeting the government’s core standards.

They have made the information available as part of the Commission’s annual performance assessment of English NHS trusts.

The boards of all 391 NHS trusts have declared whether their organisation met the necessary level of performance during the year to March 31 2008.

The government, which sets the standards, has said that they aim to ensure “health services are provided that are safe and of acceptable quality”, and all trusts should be meeting them.

Patients and the public can see and comment on what local trusts say about whether they measure up against 24 core standards (with 44 parts) in areas like safety, clinical effectiveness and patient focus.

The Commission will take a view on whether the declarations are accurate
but only after carrying out a rigorous cross-checking exercise.

The Commission cross-checks the declarations using publicly available information from sources such as clinical audits, surveys and performance data from other regulators. It holds some 1,700 items of data, including information from over 30 different bodies.


The Commission also takes into account local intelligence, gathered by its regional assessors across the country.


It also systematically collects comments from representatives of patients and the public such as patient and public involvement forums and the overview and scrutiny committees of local authorities. Having carried out the analysis, it will inspect at least one in five trusts.

Analysis of this year’s declarations shows:

· across the NHS, the overall compliance rate declared in 2007/2008 increased to 95.7 percent from 94.2 percent in 2006/2007

· for the second year in a row there has been a significant increase in the number of acute and mental health trusts declaring full compliance.

However there has been a decline in the number of primary care trusts declaring full compliance (23 percent in 2007/2008 compared to 31 percent in 2006/2007

· the standards where trusts improved performance cover, compliance with guidance from the National Institute of Healthcare Clinical Excellence (NICE), patient privacy and learning from things that go wrong

· the standards trusts struggled with cover issues such as the decontamination of medical devices, records management, tackling discrimination, and staff development and training

· 39.4 percent of trusts believe they fully met the standards in 2007/2008 compared to 40.1 percent of trusts in 2006/2007

· positive comments from the public on trusts’ declarations increased to 71 percent from 65 percent in the previous year.

In the 2006/2007 annual performance assessment of the NHS, 33 trusts scored ‘weak’ for quality of services. During the 2007/2008 year, the commission visited these trusts to check on the progress being made to improve standards.

Of the 33 trusts, 24 had been rated as 'not met' in 2006/2007 against core standards. All but two of these trusts have declared higher levels of compliance in 2007/2008.

Anna Walker, Chief Executive of the Healthcare Commission, said: “When it comes to assessing NHS performance, these declarations offer us and the public a critical piece of the jigsaw. They tell us how well NHS trusts think they are performing against the government’s standards for the NHS.

“Overall the picture, if confirmed, is encouraging. More trusts are declaring compliance against the core standards. They are claiming improvements in important areas that really matter to patients. These include compliance with NICE guidance, levels of privacy and learning from things that go wrong.

“We are very pleased that a number of trusts that were previously rated ‘weak’ have said that they have made a significant improvement. If confirmed, this suggests that the poorer performers are making real strides.”

“However the picture on hospital acquired infection is mixed. There were improvements in two out of the three relevant standards. But overall we are still in a situation where too many trusts have self declared non compliant.”

The Commission checks on core standards are part of a pioneering system of NHS assessment that uses self-declaration, performance data and inspection to target regulatory efforts where there is evidence of a problem.


Using all of this information, the Commission's regional teams target inspections to check that trusts have performed at the level declared. All non compliance is pursued.


Around half the visits are at trusts where there is a discrepancy between what the organisation has declared and other sources of information. The rest are random spot checks, designed to monitor the self-assessment system.


Where it finds lapses, the Commission’s response can vary, ranging from requiring an action plan to launching a formal investigation.


Trusts that declare a problem are less likely to face an inspection, as long as there is evidence the organisation is tackling the issues.


By using a risk-based and targeted approach to inspection, the Commission aims to ensure that it works efficiently and effectively.


The rating reports on two areas of performance: quality of services and use of resources. For each of these, the Commission gives trusts a score on a four-point scale, ranging from ‘excellent’ to ‘weak’.


The quality of services score covers outcome indicators such as waiting times as well as compliance with the general standards.


The NHS annual performance ratings for 2007/2008 will be published on 16 October 2008.


Click here to see how trusts assessed themselves in 2007/2008: http://www.healthcarecommission.org.uk/microsites/finaldeclarations.cfm



Notes to editors:

Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.


The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RGIA) undertakes regular reviews of the quality of services in Northern Ireland.


For further information contact the press office on 0207 448 9210, or on 07917 232 143 after hours.

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