Monthly column for providers and professionals working in healthcare from Professor Ted Baker, Chief Inspector of Hospitals
I have spoken in previous columns about our patient survey programme, and the importance of hearing directly from people using services about their experiences. As well as informing our regulatory activities and helping us assess performance and track trends over time, the survey results are a useful resource for individual providers to identify where they might be able to make change to ensure high quality care for people using their services.
We have recently published the results of our 2019 maternity survey. This asked for women’s views on all aspects of maternity care — from the first time they saw clinician or midwife, during labour and birth, through to the care provided at home in the weeks following the arrival of their baby.
I was pleased to see that the majority of women had a positive experience of maternity services, particularly when it came to interacting and communicating with staff in maternity services. We also saw an important improvement across a greater number of questions compared to the last time the survey was carried out in 2018. We have also seen positive upward trends in areas such as feeding choices and partner involvement.
However, the survey has identified some areas for improvement, particularly when it comes to continuity of carer, access to midwives after giving birth and perinatal mental health.
These predominantly positive results reflect the hard work and commitment shown by staff working in hospital maternity services across the country. I would encourage those NHS trusts providing maternity services to review their individual results and reflect on where they might be able to make improvements for the benefit of all women and their families.
Complaints made by private patients or their representatives
I have previously highlighted the need for an independent third stage complaints review process for private patient units (PPUs) in the NHS. Only NHS-funded patients have the right to take their complaint to the Parliamentary and Health Service Ombudsman (PHSO), so private patients using an NHS PPU cannot use the services of the PHSO should they be dissatisfied with the outcome of a complaint they have raised with the trust.
It is important to understand that as well as PPUs, this applies to all other independent healthcare providers, including private cosmetic services and independent ambulance services. If an independent healthcare provider treats a patient who is NHS-funded, that patient can take their complaint to the PHSO. If the same independent healthcare provider treats a patient who is not NHS-funded, that patient cannot take their complaint to the PHSO. The PHSO has changed the information on their website to clarify this position. The Independent Healthcare Providers Network has recently published an animation for patients on what to expect from independent healthcare.
CQC does not have powers to investigate individual complaints, but our assessment framework asks what arrangements are in place for the independent review of complaints where the service’s internal complaints process has been exhausted. We expect independent healthcare providers to be able to demonstrate what these arrangements are in their policy, and in information materials for private patients. Some services subscribe to the Independent Sector Complaints Adjudication Service (ISCAS), and private patients of those services can use the ISCAS independent third stage to review their complaint. Where an independent healthcare provider has no independent review system, the complainant’s only option would be to consider taking legal action, and this should be made clear in the policy and in-patient complaints information.
Committee of Advertising Practice enforcement notices
The Committee of Advertising Practice (CAP) write the advertising rules which are enforced by the Advertising Standards Authority (ASA), the UK’s independent advertising regulator. They have recently published enforcement notices for advertising non-invasive prenatal testing (NIPTs), which may require action from providers.
Adverts for NIPTs commonly cite ‘detection rates’ of 95% and higher for their accuracy in screening potential genetic condition. The ASA has recently ruled that quoting detection rates alone in marketing material is likely to mislead consumers.
Providers are therefore being asked to take immediate action to ensure their advertising complies with the guidance. After 17 February, CAP will take targeted enforcement action which can include referral to a professional regulatory body. Read the full enforcement notice on the CAP website.
We are pleased to have entered the world of podcasting, and the first episodes of CQC Connect are now available to listen to! In the first series, we cover topics such as the importance of sharing feedback — both good and bad — on care, innovation and technology, key messages from our recent State of Care report, and outstanding general practices. You can listen via your usual podcast provider. We’re already busy planning the next series, and we’d be interested to hear if there are any topics you’d like us to cover as well as any general feedback you might have.