Safety and training must be improved

In its first annual report to parliament on the state of health care and adult social care in England, it cautioned that some services were lagging behind and that there were areas of common concern across health and social care, notably keeping people safe and staff training. Improvements included: reduced hospital waiting times in A&E and waits for nonemergency care; reductions in MRSA and C.difficile rates of 34% and 35% respectively, over the last 12 months; and increased reporting of serious incidents to the National Patient Safety Agency. In addition, 63% of NHS Trusts, 77% of adult social care providers and 95% of councils were also rated “good” or “excellent” last year. Access to services that help prevent unnecessary emergency admissions to hospital has also improved, as well as services that help patients return home quickly, while progress has been achieved in supporting people to live independently at home. However, a number of concerns were also highlighted. High on the list was patient safety – despite national progress, the reporting rate of incidents varies significantly across organisations. Although 90% of patient contact takes place at GP practices, only 3,417 incidents were reported in the year to July 2009, compared to 693,700 from hospitals. Furthermore, 9% of NHS Trusts did not comply with the minimum standard on child safeguarding. Workforce training on safeguarding, life support and fire safety also showed room for improvement – in 2009, the standard requiring NHS staff to participate in mandatory training programmes had the lowest overall compliance rate of all standards. CQC pointed out that services would be operating in a different environment in future, with pressure on finances adding to continuing increases in demand and rising expectations. It said that the next big challenge for health and social care is to accelerate efforts to make services more joined up and centred around people’s needs. The report argued that joining up health and social care can deliver both better care and greater efficiency. Some older people are admitted to hospital as emergencies twice or more each year, which could be prevented if they were cared for better in the community. The Commission claimed that up to £2 billion could be saved annually from hospital budgets if each area were able to reduce the number of older people admitted repeatedly to hospital in an emergency, and the number of days these people spend in hospital, to the levels seen in the best performing areas of the country. CQC’s interim chair, Dame Jo Williams, said: “Successes have come in areas that really matter to people such as reducing hospital infection rates and helping people live independently at home. But we are mindful of the fact that pockets of poor practice remain, which must be addressed.”