Independent hospitals rate highly but concerns remain over safety and children’s services

Independent sector hospitals rate highly for outpatients and diagnostic imaging but there are concerns that acute services for children and young people need improvement, the CQC said today.

Although 50% of acute services for children and young people were rated ‘good’ and 11% as ‘outstanding’ as of July 2018, 37% were rated ‘requires improvement’ while 3% were deemed ‘inadequate.

In its State of Care Report 2017/18, the regulator said because relatively few children are treated in the sector, specialist paediatric staff are not always on site to identify issues such as safeguarding concerns. In addition, it warned that staff working in facilities where ‘very low’ numbers of children are treated could risk losing their skills and expertise.

‘We also had concerns at some services about having the correct experienced clinical support for a deteriorating child,’ said the report.

The CQC raised concerns over safety across the sector in its report on independent hospitals published in April. It said safety remained the key area where improvement was needed, with 39% of independent hospitals rated ‘requires improvement’ and 1% ‘inadequate’ on the safety measure as of July 2018.

On the CQC’s other measures, however, the sector continued to perform well. No independent sector providers are rated ‘requires improvement’ or ‘inadequate’ on the caring question, while over 90% are either ‘good’ or ‘outstanding’ when it comes to being responsive.

In terms of services, outpatients and diagnostic imaging services received the highest ratings, with 79% rated ‘good’ and 6% ‘outstanding’, closely followed by surgical services where over 75% of services received the two highest ratings.

Overall, 63% of independent sector hospitals were rated ‘good’ and 8% ‘outstanding’ as of July 2018, while 28% required improvement and 0.5% were rated ‘inadequate’.

The report said that although the overall profile ratings of core services in the sector is broadly similar to that for small NHS acute sites with no emergency provision, it is not easy to make valid comparisons between independent and NHS facilities.

‘NHS acute hospitals also mostly provide urgent and emergency care and admit patients through an emergency department, which the independent sector does not. Independent hospitals therefore have the advantage of not facing the pressure from emergencies that most NHS acute hospitals do, but this also means they have less expertise and infrastructure to manage very unwell and deteriorating patients,’ it said.

Safety has become a key issue for the sector over the past year in the wake of the Ian Paterson case. The Paterson Inquiry is due to begin hearing evidence from experts and specialists from across the sector over the next few weeks and will publish its report next summer.

Responding to the CQC report, NHS Partners Network clinical director Dr Howard Freeman said: ‘We welcome the CQC’s State of Care report, which shows that over 70% of independent acute hospitals are rated good or outstanding, with the responsiveness and caring nature of services highlighted as a particular strength.

‘The CQC’s report also highlights the significant number of independent hospitals which are providing outstanding care for children and young people. We want to see this best practice spread throughout the independent sector and we will work to ensure robust processes are in place in line with CQC guidelines which prioritise the safety and wellbeing of vulnerable children.

‘Ahead of what is likely to be one of the toughest winters on record for the NHS, it is vital that independent sector providers are fully integrated into local system planning to ensure that all available resources are utilised so that NHS patients can access safe, timely and high quality care free at the point of use.’