It’s time to reform the Care Quality Commission so patients can make an informed choice

The Amanjit Jhund NHS Column

The news this week has contained reports of the discrepancy between the Dr Foster independent medical report and the official Government ratings on hospitals and trusts released by the Care Quality Commission (CQC). It has been suggested by the Dr Foster report that 12 hospital trusts are failing, despite 9 of those trusts receiving a Good or Excellent rating from the CQC.

This discrepancy between the two ratings and assessment systems is vitally important. As we look to expand patient choice and control in the health service it is fundamentally important that we give patients the tools and information to enable them to make fully informed decisions about their healthcare choices.

The CQC ratings system has been under fire from within the medical profession for years. It has been my experience that there is often very little correlation between the standard of care offered by a trust and its rating from the CQC. Indeed I have worked in some trusts rated as excellent by the CQC where I quite frankly would not put my dead dog, let alone allow myself or a member of my family to be treated there. At the same time I have also worked in trusts rated as poor by the CQC where I would be happy to be treated myself.

One of the first things that you are taught at medical school is that an uninformed choice is often worse than having no choice at all. Offering a patient two different treatments whilst not explaining success, or failure rates, complications or side effects is in many ways worse than the doctor simply choosing the best available treatment based on their own knowledge. Hence in medicine there is always an imperative to inform patients and allow them to make fully informed decisions.

If in turn we also wish to offer increasing patient choice with regards to treatment providers or hospital trusts then we must ensure that the CQC, as the official organisation, is providing patients with an accurate assessment of the standard of care at the hospitals they are supposed to inspect.

Currently, the CQC ratings are based upon the trusts meeting both quality of financial and service elements. These are further broken down into core standards, commitments and national priorities. The problem remains that although measurement of standards is integral to both providing quantifiable improvements to the NHS and facilitating patient choice, if the parameters of measurement are flawed then they can have the opposite effect. Flawed standards can provide an artificial sense of improvement and they can provide patients with a misleading impression of the trusts that they are supposed to inspect.

For this reason it is vital that as we look to increase patient choice that we look to reform the CQC and its inspection of our hospitals and trusts.