We wrote to the Care Quality Commission (CQC) because Norfolk & Suffolk NHS Foundation Trust (NSFT) has been claiming that the forthcoming CQC inspection is routine/random and that the Campaign to Save Mental Health Services in Norfolk & Suffolk was being inaccurate and misleading to write that NSFT had been selected as a priority for early inspection.
Our question to the CQC was:
“We write from the Campaign to Save Mental Health Services in Norfolk & Suffolk.
Could you please supply us with information, preferably electronically to the address from which this email is sent, relating to the selection of our local trust, Norfolk & Suffolk NHS Foundation Trust (NSFT), as one of the first to be inspected under the new regime as detailed on your website?
If NSFT is one of the CQC’s ‘priorities for inspection following CQC’s analysis of evidence’ as described on your webpage linked to above, please supply the evidence and the analysis.”
Decision to schedule Norfolk and Suffolk NHS Foundation Trust for Inspection
The CQC have committed to inspect all mental health provider organisations within the next two years. The decision on when to inspect a particular service takes account of a number of factors including:
- CQC intelligent monitoring
- Information from a wide range of stakeholders
- Published performance metrics
- Make up of services offered by the provider
- CQC inspection capacity in each region
- CQC requirement to pilot inspections in a range of service types
- The outcome of previous inspection activity
In the case of Norfolk and Suffolk NHS Foundation Trust, each of these factors was taken into consideration.
At the time of scheduling, the Trust had received a number of recent inspections and some locations had been deemed to have moderate and minor non-compliance on certain measures (the Trusts were not meeting certain standards). All of these inspection reports are available on our website.
Local inspectors had reported that a difficult cost saving exercise was creating concern among some members of staff.
Meetings had been held between the CQC Deputy Chief Inspector with responsibility for mental health, an inspection manager, and Norman Lamb MP. Norman Lamb MP has also corresponded with CQC Chief Executive, David Behan regarding the Trust.
Monitor also corroborated the above findings and the Trust had been placed on enhanced surveillance by the East Anglia Quality Surveillance Group.
The most recent NHS Staff Survey had highlighted some issues including:
- Suffering work-related stress in the last 12 months
- Experiencing physical violence from patients/relatives in the last 12 months
- Experiencing harassment, bullying or abuse from patients/relatives in the last 12 months
- Experiencing harassment, bullying or abuse from staff in the last 12 months
- Percentage reporting good communication between senior management and staff
None of these factors individually resulted in the Trust being scheduled at this particular time, but they all fed into the scheduling team’s considerations.
The reply from the CQC demonstrates that many of this campaign’s concerns are shared by: David Behan, Chief Executive of the CQC; Care Minister and local MP, Norman Lamb; Monitor; NHS England’s East Anglia Quality Surveillance Group.
Concerns have also been raised by this campaign, local councillors, the Royal College of Psychiatrists, the BMA and Unite, Unison and the Eastern Daily Press (EDP) and during the HealthEast public consultation, but the CQC doesn’t refer to them. Isn’t it depressing, even in the post Francis Report world, that quangos and bureaucrats only seem to take other quangos and bureaucrats seriously?
Rather than forming bureaucratic working groups, creating voluminous documentation and diverting clinicians from treating people to participate in mock inspections to prepare for the CQC visit, wouldn’t NSFT do better by concentrating on the correcting the crises of its own creation of which we are all only too well aware?