The Care Quality Commission performance ratings show that the NHS is performing well against a rigorous assessment on quality, with more Trusts rated “excellent” or “good”.
In particular, the CQC commended the significant improvement in ratings for financial management, which it described as “good news” in the face of predicted pressures on public spending. Overall compliance with standards has increased from 95% to 96% and the assessment showed that more people are seen in A&E within four hours, more receive treatment within 18 weeks of referral, and there are large reductions in MRSA and Clostridium difficile cases. However, only about half of Trusts fully met all core standards and compliance declined in the acute sector with 59% fully met this year compared to 69% last year. Concerns were further raised about the 20 Trusts that rated “weak” on “quality” and the CQC highlighted a further 27, which have not been higher than “fair” for quality and financial management in the last four years. The proportion of cancelled operations also rose for the second year in a row to almost one per cent. This equates to 63,000 operations cancelled at the last minute for non-clinical reasons. In addition, while MRSA and C. difficile rates are decreasing, acute Trusts need to do more on infection control. This year 48 acute Trusts did not meet at least one of the three relevant standards, compared to 44 last year. Of particular concern was the fact that fewer acute Trusts were rated “excellent” and more were rated “fair”. The CQC explained that there is increased scrutiny on child safeguarding and healthcare-associated infection; while a significant number did not meet new indicators on quality of basic maternity data and participation in heart disease audits – which are vital to monitor quality of care. In addition, only 37% of acute Trusts met the required level of performance on specialist stroke care. Overall, thirty-seven Trusts were rated double-excellent, including The Royal Marsden NHS Foundation Trust, which was doubleexcellent for the fourth year running. Barking, Havering and Redbridge University Hospitals NHS Trust was the only Trust rated doubleweak, down from six Trusts last year. Cynthia Bower, CQC chief executive, said: “It is clear that some Trusts are struggling and that some issues are proving tough nuts to crack. My biggest concern is those Trusts that are ‘weak’ and persistently ‘weak’ or ‘fair’. They must do better for their patients. “I want to ring the alarm bell in the boardrooms of these organisations. Next year, all Trusts must register with us to legally function. It is clear that many have significant work to do and a short time in which to do it.” Commenting on the publication of the performance ratings, King’s Fund chief executive, Niall Dickson, said: “Patients served by the hospitals and other services that consistently rank at the bottom have a right to know why these organisations are not providing the quality of services that is expected from them. We need to understand whether the problems are managerial or structural, and what is being done to help them raise their game. “It is also worth remembering that the current performance has been achieved in a period of funding growth – the big challenge going forward will be to maintain and improve those standards when money is tight.”
