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67-812: Worcestershire Acute Hospitals NHS Trust is an NHS trust which runs three hospitals and one ward in Worcestershire , England: The Worcestershire Royal Hospital in Worcester , the Alexandra Hospital in Redditch , Kidderminster Hospital and Treatment Centre in Kidderminster , and Burlingham Ward at Evesham Community Hospital in Evesham . Services in Kidderminster and Redditch have been under threat for many years. Proposals to downgrade Kidderminster hospital provoked

134-476: A blood test and misdiagnosed his condition. The coroner described this as "a failure to provide basic medical care". If the illness had been identified the boy would have survived. The Carnall Farrar consultancy was engaged to review emergency care in the trust in January. They found that 700 patients a month were waiting more than 12 hours in the emergency department before being admitted or discharged, far more than

201-486: A deficit of £58 million against turnover of £364 million. It had been given a temporary working capital facility of £19m. The 30-year private finance initiative scheme at the Worcestershire Royal Hospital which runs until 2032 costs the trust about £13.6m a year. In February 2016 it was expecting a deficit of £65 million for the year 2015/6. In 2019 it rejected a proposal by NHS Improvement to achieve

268-626: A duty to act on signals of poor performance on quality and safety data, and yet many of the papers presented to them have been found to be lacking good data visualisations. The High Court of Justice decided in December 2019 that NHS trusts were not charities for the purposes of the Local Government Finance Act 1988 , so they have to pay business rates at the full rate. A study by the University of Exeter in 2020 found that in 70 out of

335-436: A good or outstanding CQC rating was associated with a better quality of life for residents. High staff wages were linked with better CQC ratings, and short-staffed homes were linked with worse CQC ratings. Michelle Fenwick, the director of Heritage Healthcare Franchising, complained in December 2019 that the fees charged to home care providers, which are proposed to be based on the number of clients supported, were unfair and

402-435: A greater degree and, for the first time, across localities. The organisation failed to meet its inspection targets during the second quarter of 2015–16. 70% of adult social care inspections had been undertaken and 61% of primary medical services. An exception to this was inspections of hospital acute services where targets were slightly exceeded, an additional two inspections having been made in this sector. In December 2015

469-634: A male carer and mistreated by four others. The standard of care at the nursing home had been rated "excellent." The victim was an 81-year-old woman with Alzheimer's disease and severe arthritis . Although the commission's primary function is to enforce national standards including safeguarding the vulnerable and "enabling them to live free from harm, abuse and neglect" the CQC responded by stating that they "should not be criticised for failing to protect people from harm" and could not be expected to spot abuse "which often takes place behind closed doors." Whorlton Hall

536-486: A meeting where deletion of a critical report was allegedly discussed. Bower and Jefferson immediately denied being involved in a cover-up. The Guardian newspaper reported on 19 June 2013 that Tim Farron MP had written to the Metropolitan Police asking them to investigate the alleged cover-up. Following an investigation, CQC found that Jefferson had not been party to any alleged 'delete' instruction. Jefferson

603-616: A national basis, deal with NHS-wide issues. An example is NHS Blood and Transplant . Care Quality Commission The Care Quality Commission ( CQC ) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom . It was established in 2009 to regulate and inspect health and social care providers in England. It was formed from three predecessor organisations: The CQC's stated role

670-501: A result of an improved risk management and a stronger learning culture." They also said the research was based on a limited sample of inspections which took place over five years ago. In August 2019 the Avon and Wiltshire Mental Health Partnership NHS Trust was fined £80,000 as a result of a prosecution brought to court by the CQC. This followed the fall of a patient from a hospital roof which led to serious injury. The service had been warned of

737-565: A safe service”. In April, after a major incident at Worcestershire Royal Hospital, when seven patients had to be cared for in a corridor, Neal Stote, chairman of the Save the Alex campaign claimed that reconfiguration plans meant that "Worcestershire Acute Hospitals NHS Trust is trying to make us go to a hospital which is not only hard to get to but a hospital which, when you get there, is unable to cope." The Care Quality Commission carried out an inspection of

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804-510: A £64.4 million deficit for 2019-20 and would only accept a target £73 million deficit, about the same as the result achieved in 2018-9. It has opened nearly 100 additional beds at a cost of about £22.5 million. NHS trust NHS trusts were established under the National Health Service and Community Care Act 1990 and were set up in five waves. Each one was established by a statutory instrument . NHS trusts are not trusts in

871-618: A ‘vexatious complainant’ after raising concerns about his treatment at Worcestershire Royal Hospital over several years. The Trust's former Chief Operating Officer, Stewart Messer, attempted to ban Stuart Gardner, a UNISON representative of the West Midlands Ambulance Service from Trust premises in January after he told the BBC about 18 patients being treated in corridors at the Worcester Royal Hospital. Messer claimed

938-636: Is a private hospital in County Durham which had previously been owned by the same company as Winterbourne View. An undercover investigation by the BBC Panorama programme found evidence that vulnerable clients with autism or learning difficulties were physically and verbally abused by staff. Patients were also physically restrained. The current owners of the service, Cygnet have stated that all patients have now been transferred to other hospitals. The service had been visited at least 100 times by official agencies in

1005-489: Is already a vulnerable society, with the worst accessibility to health services in the region, and will introduce substantial inequalities with the populations of Redditch, Bromsgrove, Studley, Alcester and neighbouring areas being significantly worse off than all other areas in Worcestershire." The trust is currently under the leadership of group chief executive Glen Burley and group Chair Russell Hardy In November 2018 it

1072-479: Is also intended to extend the chemotherapy services available on the site. In December 2013 the Trust had to cancel non-urgent operations and appointments due to increased pressure on their A&E units. In April 2014 it was revealed that the Trust had mislaid up to 270,000 ultrasound scans which were stored on obsolete technology dating back to 2004. Andrew Brown, whose complaints led to this revelation had been labelled

1139-431: Is clearly unacceptable from a public body in which taxpayers are placing their trust." In July 2016 the commission issued an apology after admitting that up to 500 Disclosure and Barring Service (DBS) certificates submitted by applicants to become registered managers and providers had been lost during a planned office refurbishment; a locked filing cabinet had been incorrectly marked up to be taken away and destroyed. In

1206-451: Is to make sure that hospitals, care homes, dental and general practices and other care services in England provide people with safe, effective and high-quality care, and to encourage those providers to improve. It carries out this role through checks during the registration process which all new care services must complete, as well as through inspections and monitoring of a range of data sources that can indicate problems with services. Part of

1273-480: The Care Quality Commission . Board members are, from November 2014, subject to a fit and proper person test . All trust boards are required to have an audit committee consisting only of non-executive directors, on which the chair may not sit. This committee is entrusted not only with the supervision of financial audit , but of systems of corporate governance within the trust. Hospital board members have

1340-478: The 1200 homes inspected were rated as outstanding. In September 2016 the CQC said that 40% of nursing homes in the country were rated as "requiring improvement" or "inadequate". It is a legal requirement for homes to clearly display their CQC ratings on their websites, but a July 2017 survey carried out by Which? found that 27% of care homes surveyed either completely failed to display them or placed them where they were very difficult to find. As of September 2018,

1407-399: The 2017 New Year period. Many other patients at Worcester Royal Hospital during the first week of January spoke of long waits, patients in corridors, overstretched staff doing their best. Similar problems are in other NHS hospitals. A patient died from an overdose of DNP , which overworked medical staff failed to recognise in time. In December the trust diverted emergency patients away from

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1474-521: The 213 trusts all the board members were white. Overall BAME representation at board level was 8.9%. Medical directors of BAME ethnicity accounted for 19.4%, about the same as the overall percentage of BAME doctors. In September 2015 Jeremy Hunt was reported as saying "I think we do have too many trusts as independent organisations" in a context where mergers between trusts and the establishment of chains of hospitals were being discussed. Subsequently Simon Stevens made it clear that he did not expect

1541-476: The 34 homes closed during Cynthia Bower 's tenure after failing their inspection later reopened with a new name or under new ownership, but with similar problems. The campaigning charity Compassion in Care told the magazine that if a home changed name or ownership it was then listed by the CQC as "new services" and "uninspected", and there was no link to reports on the same establishment under different ownership, even if

1608-667: The A&;Es at two hospitals, the Worcestershire Royal Hospital and the Alexandra Hospital in Redditch. During the winter the trust had to divert emergency patients elsewhere at least 65 times. 35% of patients with suspected cancer waited longer than two weeks to see a cancer specialist though 93% of patients should be seen within that time. In 2017-18 only 78.9% of A&E patients were seen within four hours. Eight year old Callum Cartlidge died after Worcestershire Royal Hospital failed to do

1675-452: The CQC continued to respond to concerns raised by staff. In October 2020 the Department of Health asked the CQC to investigate the use of Do Not Resuscitate (DNACPR) decisions early in the COVID-19 pandemic, when blanket DNACPR decisions were applied to all care home residents without considering individual circumstances. In March 2024, it was announced that psychotherapist Sue Evans, who

1742-567: The CQC inspectors but also the NHS staff who are diverted from other activities." They suggested a less resource-intensive approach should be adopted. A spokesman from the CQC responded: "To use rates of reported falls and pressure ulcers in isolation to determine CQC's impact is a crude measure and presents an overly simplistic view that is not borne out in the quality and safety improvements we have seen through our hospital inspections. It also fails to recognise that increased reporting of such incidents may be

1809-495: The CQC rated almost 3,000 out of 14,975 care homes in England as inadequate or needing improvement. The care home Horncastle House was closed by CQC in September 2018 as an urgent enforcement action to protect residents. In November 2018 the CQC had rated 1% of adult social care providers as inadequate, 17% as requiring improvement, 79% as good and 3% as outstanding in that year. A 2021 review of 20 care homes in England found that

1876-450: The CQC said that an urgent review was carried out when the issue was discovered and it was found that "none of these referrals contained information about immediate risk of severe harm to people". Sutcliffe apologised for the error and said an independent investigation "will assist us in ensuring we improve our systems to avoid something like this happening again". In October 2018 CQC's Chief Executive Ian Trenholm stated that he wanted to make

1943-541: The CQC stated that it was finding it difficult to meet their inspection target of GP practices and had therefore drafted in 'bank' inspectors and authorised staff overtime to deal with the backlog. In October 2014 Field announced that the commission was going to begin inspecting health systems across whole geographical areas from 2015, including social care and NHS 111 . There are suggestions that it could inspect clinical commissioning groups . Behan admitted in March 2015 that

2010-451: The Health and Social Care Act 2008 does not distinguish between types of health or social care service, in practice, the CQC has different regulatory approaches for: Cross-sector inspections In November 2009 Barbara Young , then the CQC chair, resigned from the commission when a report detailing poor standards at Basildon and Thurrock University Hospitals NHS Foundation Trust was leaked to

2077-477: The Journal of Health Services Research and Policy studied rates of falls which led to harm and pressure ulcers in more than 150 hospitals following CQC inspections. Rates of improvements in these criteria slowed after the inspections. Lead researcher Ana Cristina Castro stated that the inspection regime "creates a significant pressure on staff before and during the inspection period, and also significant costs, not just of

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2144-548: The Public Accounts Committee (PAC) was critical of the regulator, and said that it was "behind where it should be, six years after it was established". Meg Hillier MP, the chair of the PAC, noted that reports prepared by the CQC contained many errors; one foundation trust said that their staff had found more than 200 errors in a draft CQC report. Hillier said "The fact these errors were picked up offers some reassurance, but this

2211-536: The Worcestershire Royal Hospital. Consequently, the future of the Alexandra Hospital Accident and Emergency department was in doubt. Their resignation letter accused “successive management decisions” of undermining services at the Alexandra, which they say has “led to the self-fulfilling prophecy of failing and unsustainable services” and that the proposed service model would be “neither an A&E service nor

2278-428: The commission would not be able to inspect all acute trusts before the end of 2015 as it had intended. In February 2015, it reported that it was missing its targets for following up on the safeguarding information it received that might indicate that patients are at risk. He also said the CQC would update its oversight in line with the growth of new provider models and would begin looking at care quality along pathways to

2345-611: The commission's remit is protecting the interests of people whose rights have been restricted under the Mental Health Act . Until 31 March 2009, regulation of health and adult social care in England was carried out by the Healthcare Commission and the Commission for Social Care Inspection . The Mental Health Act Commission had monitoring functions with regard to the operation of the Mental Health Act 1983 . The commission

2412-405: The community and the hospital trusts are generally planning to follow these initiatives. Foundation trust status may be applied for by the above categories of NHS trust. Successive governments have announced that all NHS trusts should become foundation trusts, and deadlines have been set for this transformation, which have repeatedly been missed. Several special health authorities , organised on

2479-534: The establishment of Independent Community and Health Concern . Their candidate Dr Richard Taylor defeated David Lock the sitting Labour MP in the 2001 general election . The building of the new Treatment Centre, in Kidderminster was handled by Durrow healthcare consultancy . In November 2013 further proposals to reduce services in Redditch were opposed by Redditch, Bromsgrove and Stratford councils who claimed "The removal of services from Redditch will leave what

2546-487: The information held by the organisation more widely available to the public and that he also intended to make CQC an easier organisation to do business with and a better place to work. A chief digital officer was to be appointed as part of this process. In January 2019 it was announced that Mark Sutton would take on the role of chief digital officer from April 2019. In April 2019 a study by the University of York published in

2613-482: The legal sense but are in effect public sector corporations . Each trust is headed by a board consisting of executive and non-executive directors , and is chaired by a non-executive director. There were about 2,200 non-executives across 470 organisations in the NHS in England in 2015. Non-executive directors are recruited by open advertisement. All trusts ( foundation trusts and those which have yet to reach foundation trust status) are regulated by NHS England and

2680-539: The media. The report found that "hundreds of people had died needlessly due to appalling standards of care." One month earlier the commission had rated the quality of care at the hospital as "good." In August 2012, chief executive David Behan commissioned a report by management consultants Grant Thornton . The report examined the CQC's response to complaints about baby and maternal deaths and injuries at Furness General Hospital in Barrow-in-Furness, Cumbria and

2747-564: The new owners were linked to the previous owners, and there was no follow-up inspection if problems had been identified. They had found 152 homes re-registered as new, when they had only changed owner or name. The commission had identified safety concerns in more than 40% of the homes it had inspected, and 10% were rated as inadequate. In April 2016, it was reported that 44% of care homes in the South East inspected over an 18-month period were rated as inadequate or requiring improvement. Only 0.9% of

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2814-537: The organisation's previous management had been "totally dysfunctional" and admitted that the organisation was "not fit for purpose." On 20 June 2013, Behan and Prior agreed to release the names of previously redacted senior managers within the Grant Thornton report, who it is alleged had suppressed the internal CQC report. The people named were former CQC Chief Executive Cynthia Bower, deputy CEO Jill Finney and media manager Anna Jefferson. All were reportedly present at

2881-445: The period of August 2016 to January 2017 the CQC sent questionnaires to inpatients of NHS hospitals who had been service users in the month of July 2016. 77,850 surveys were sent out. In October 2016, a briefing paper issued by the organisation stated that no directorate was meeting objectives for producing reports on time. Of services which had been inspected over half had not improved their rating when re-inspected, with 45% staying at

2948-456: The potential risk in 2011. A spokesman for the trust said they were working with NHS England to make improvements. In September 2019 the Barking, Havering and Redbridge University Hospitals Trust stated their inspection by the CQC had become drawn out "due to availability of inspectors". In response, the CQC's deputy chief inspector of hospitals Nigel Acheson said that the inspection "remains within

3015-427: The previous five years the 18-week waiting list for planned hospital treatment had increased from involving 3 million patients to 4.4 million. In March 2020 it was announced that most inspections would continue as planned following the outbreak of the coronavirus, and that this position would be kept under review. It was subsequently announced on 16 March that routine inspections were being temporarily paused, however

3082-687: The published CQC timeframes for inspection." The inspection began on 3 September and is expected to be completed in mid November. In October 2019 Professor Ted Baker, the Chief Inspector of Hospitals at the CQC stated that "little progress" has been made on improving patient safety in the NHS over the last 20 years. In the same month the CQC published their State of Care report. This stated that 44% of A&E departments were rated as requiring improvement and 8% were rated as being inadequate. 36% of NHS Hospitals were given ratings of requiring improvement on safety with 3% considered inadequate in that area. Over

3149-497: The remaining NHS trusts to become foundation trusts, saying "We are frankly kidding ourselves if we think the non-FTs are going to pass the kinds of criteria that have been set by Monitor ." There are several types of NHS trusts: Over time the distinction between different types has eroded, and both hospital and mental health trusts have taken on responsibility for various community services. Sustainability and transformation plans all propose to move services out of hospitals into

3216-521: The safety of service users who were more vulnerable due to mobility issues or learning disabilities. In March 2018 the Public Accounts Committee reported that although the regulator had "improved significantly" there was "no room for complacency" in the organisation which had "persistent weaknesses and looming challenges". Whilst there had been improvements in the timeliness of hospital inspection reports since 2015, only 25% of reports on hospitals where less than 3 services were inspected were published within

3283-574: The same rating and 10% having a lower rating. Following the cyber attacks on NHS systems in May 2017 it was announced that the CQC will be asking probing questions to assess data security as part of its inspection process. After the Grenfell Tower fire in June 2017 letters were sent to around 17,000 care homes, hospitals and hospices requesting that they review fire safety processes, paying particular attention to

3350-400: The service was poor. It could take more than four months for a new service to be registered. She complained that assessments were too subjective. The commission has also been accused of being a barrier to innovation and impeding a shift to digital services because they insisted on paper records, and there were claims that some inspectors did not understand electronic records. Winterbourne View

3417-484: The staff were upset. The Trust later agreed with the union they did not have the authority to ban the paramedic from its premises and an apology was issued for suggesting he should be. Nurses at the Alexandra Hospital complained of serious bullying by their seniors. In February it was reported that four emergency consultants had resigned from the Woodrow Drive hospital and another emergency consultant had resigned from

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3484-462: The target of 50 days. It was intended that 90% of reports should meet the target. The PAC also noted that GPs had felt burdened by the CQC's regulation practices. In response David Behan stated that he accepted the committee's recommendations and did not underestimate the task at hand. In July 2018, the CQC stated that 96 safeguarding concerns had not been passed on to local authorities over the last 12 months. Andrea Sutcliffe, acting chief executive of

3551-507: The trust had reported. Waiting in corridors had "largely been normalised and accepted as standard practice” and ambulance handover delays were worsening. In September the trust announced that it needed 208 extra beds, increasing its current bed base by nearly a third, to reach a relatively safe occupancy level of 91%. The trust performs about 95,000 planned and emergency operations each year, with 140,000 A&E attendances and about 500,000 outpatient appointments. In September 2015 it predicted

3618-409: The trust's accident and emergency departments in March. They found numerous examples where patient safety was at risk. Medication was not given in a timely manner, patient notes were not up-to-date and there were "inadequate" security arrangements. In September Redditch and Bromsgrove Clinical Commissioning Group asked local GPs not to refer patients to the Trust over the next three months because it

3685-477: The year before the abuse was found out, including visits by the Care Quality Commission, Durham council and local NHS bodies. It has since been closed. A former CQC inspector Barry Stanley-Wilkinson has alleged that he had raised concerns about a "very poor culture" at the service in 2015. Stanley-Wilkinson said that he worked at the CQC for a decade and that this was the only report he had written which

3752-502: Was "more likely than not" that Ms Finney had ordered the deletion of an internal report by Louise Dineley, the CQC's head of regulatory risk. The CQC started litigation against Grant Thornton claiming a contribution towards any "damages, interests and/or costs" incurred in the case. Residential establishments, unlike hospitals, can easily be closed, or sold, and reopened with a new identity. Private Eye reported in November 2015 that most of

3819-412: Was a private hospital at Hambrook , South Gloucestershire , owned and operated by Castlebeck. It was exposed in a Panorama investigation into physical and psychological abuse suffered by people with learning disabilities and challenging behaviour , first broadcast in 2011. One senior nurse had reported his concerns directly to CQC, but his complaint was not taken up. The public funded hospital

3886-558: Was announced that the Hereford and Worcester Fire and Rescue Service 's community risk team would be running an enhanced hospital from home service to help discharge patients from the hospital in Redditch for six months. The Trust opened a new cancer treatment unit which has three linear accelerators in January 2015, a partnership with University Hospitals Coventry and Warwickshire NHS Trust , which it hopes will treat about 1,500 patients per year who previously had to travel for radiotherapy. It

3953-425: Was cleared of any wrong-doing and CQC apologised for the distress caused by the allegation. Finney subsequently started litigation seeking at least £1.3 million libel damages from the CQC on the basis that the CQC's current chair David Prior and chief executive David Behan abused their power and acted maliciously in publishing allegations that she ordered a "cover-up" of its failings. The Grant Thornton report said it

4020-527: Was established as a single, integrated regulator for England's health and adult social care services by the Health and Social Care Act 2008 to replace these three bodies. The commission was created in shadow form on 1 October 2008 and began operating on 1 April 2009. The commission has three chief inspectors who are also board members: The Commission's board also contains a number of non-executive directors. Previous board members have included: In August 2013

4087-450: Was instigated by a complaint from a member of the public and "an allegation of a "cover-up" submitted by a whistleblower at CQC." It was published on 19 June 2013. Among the findings, the CQC was "accused of quashing an internal review that uncovered weaknesses in its processes" and had allegedly "deleted the review of their failure to act on concerns about University Hospitals of Morecambe Bay NHS Trust." One CQC employee claimed that he

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4154-410: Was instructed by a senior manager "to destroy his review because it would expose the regulator to public criticism." The report concluded: "We think that the information contained in the [deleted] report was sufficiently important that the deliberate failure to provide it could properly be characterised as a ' cover-up '." David Prior, who joined the commission as chairman in January 2013, responded that

4221-413: Was not published. In response the CQC stated that reports went through a "rigorous peer review process" and the draft report "did not raise any concerns about abusive practice". They also said: "We are in the process of commissioning a review into what we could have done differently or better in our regulation of Whorlton Hall and these allegations will be fully investigated as part of this. We will update on

4288-533: Was put into special measures in December 2015 after a Care Quality Commission inspection in July. It was still rated inadequate in June 2017, and performance, particularly in emergency care, had deteriorated. The trust was singled out by the West Midlands Ambulance Service as one of two in the region responsible for the most serious delays in ambulance turn around times. Two patients died while waiting on hospital trolleys in corridors at Worcester Royal Hospital during

4355-509: Was shut down as a result of the abuse that took place. Cynthia Bower , then the chief executive of the commission, resigned ahead of a critical government report in which Winterbourne View was cited. Ash Court is a residential nursing home for the elderly in London, operated by Forest Healthcare . In April 2012 hidden camera footage was broadcast in a BBC Panorama exposé which showed an elderly woman being physically assaulted at Ash Court by

4422-732: Was the first to raise concerns about Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust when she worked there in 2005, along with a parent of a fifteen-year-old, were challenging the CQC in the High Court over its decision to license the Gender Plus Hormone Clinic, accusing the CQC of breaching its statutory duties under the Health and Social Care Act 2008 . The CQC regulates providers of "health or social care in, or in relation to, England", where: Health and Social Care Act 2008 , section 9 While

4489-482: Was unable to treat patients within 18 weeks of referral. Waiting times were out of control in ear, nose and throat, trauma and orthopedics, gynaecology, general surgery and dermatology. 2,347 patients had waited more than 18 weeks. 11 patients were infected after treatment at the Alexandra Hospital endoscopy unit, seven with Pseudomonas and four with Serratia . The machines for decontaminating endoscopes were more than eight years old and in need of replacement. The trust

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