Care quality in London has room for “improvement”

In England, the CQC (Care Quality Commission) is charged with regulating and monitoring healthcare quality, upholding standards and keeping providers accountable (think Ofsted for healthcare). To do this, the CQC carries out a number of announced and unannounced inspections, from which it gathers data before rating services as “outstanding”, “good”, “requires improvement” or “inadequate”.

As revealed by data published by the CQC, 50% of London’s NHS hospitals have an overall rating of “requires improvement”. This compares to 35% rated “good” and 15% rated “outstanding”.¹

Such findings underlie the challenges the NHS is facing and demonstrates the direct impact on patient care. In their State of Care report, the CQC cited staff shortages and staff burnout as key obstacles to improving care.² When stretched thin, fatigue and a lack of time to treat patients inevitably leads to a detriment in care, in addition to the direct effect on staff, as is evidenced by the recent strike action announced by the Royal College of Nursing.

Nevertheless, within the NHS there are some stand out performers, including Moorfields Eye Hospital and The Royal Marsden. Rated recently, with the CQC’s report published in November 2022, the CQC noted the improvements in leadership at Moorfields Eye Hospital as a key driver of success. Similarly, The Royal Marsden - a specialist cancer hospital - has been described by the CQC as using “innovative and pioneering approaches to provide evidence-based care”.³

The reality is that these hospitals are in the relative minority. The NHS ratings lag behind those of the independent sector, where just 6% are rated as “requires improvement”, with the vast majority rated good or outstanding (94%).

When analysing hospital ratings based on their services provided, new patterns emerge. A significant majority (at least 80%) of hospitals with specialisms in care of the elderly, children’s care and mental health treatment are rated either good or outstanding. This presents a promising picture, with the CQC defining care as good if “the service is performing well and meeting our expectations”.⁴

Yet, care quality is only relevant insofar as people are able to access that care, and so the record-long waiting times in the NHS pose the greatest challenge to patients’ ability to access quality healthcare.

Sources:

1. HealthSay analysis of CQC ratings as of December 2022
2. CQC State of Care 2021/2022. Link: https://www.cqc.org.uk/publication/state-care-202122
3. ‘CQC rates The Royal Marsden as Outstanding’ by the CQC. Available here: https://www.cqc.org.uk/news/releases/cqc-rates-royal-marsden-outstanding
4. ‘Ratings’ by the CQC. Available here: https://www.cqc.org.uk/about-us/how-we-do-our-job/ratings