Monthly column for providers and professionals working in healthcare from Professor Ted Baker, chief inspector of hospitals.
November has seen the publication of a number of resources and reports which I would like to draw to your attention.
We use surveys to find out what people think of the NHS healthcare services that they use. The results help support our regulatory activities such as registration, monitoring ongoing compliance and reviews and of course they help us assess NHS performance.
One such survey is that of people who receive community mental health services. This year’s survey gathered information from more than 12,000 people, and the results were published earlier this month.
Worryingly, this year’s survey revealed that people’s experiences of the care they receive from community-based mental health services have continued to deteriorate. It highlighted concerns around access to care, care planning and support for people with mental health conditions in relation to physical health needs, financial advice or benefits.
The survey results have been shared with providers to review the experiences of people who use their services and to make improvements where needed. You can see the key findings for England and the results for NHS trusts on our website.
Staying with mental health, the Healthcare Safety Investigation Branch (HSIB) has published a report highlighting the variation in mental health care across emergency departments (ED). It sets out four recommendations aimed at improving patient care which focus on funding; standardising and renewing guidance; and ensuring parity of esteem between the physical and mental health needs of patients.
The report reinforces how important it is for emergency mental health care to be available to anyone that needs it 24 hours a day, seven days a week.
Last year we introduced changes to strengthen our assessment of the quality and safety of care provided to people with mental health needs during our inspections of acute hospitals. Mental health inspectors now routinely participate in inspections of acute trusts; including those with emergency departments. New key lines of enquiry focusing on mental health have also been added to our inspection frameworks, and updated guidance, tools and training have been developed for inspectors. We continually evaluate our approach to identify where we might be able to further strengthen this important part of our acute hospital assessments.
Perhaps one of our lesser widely known roles is that of enforcing the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R). Medical ionising radiation includes x-rays and nuclear scans, and treatments such as radiotherapy.
Every year we produce an annual report on activity relating to our enforcement of IR(ME)R, giving a breakdown of the number and type of notifications we received from healthcare providers, when patients were exposed to radiation either when it was unintended or when they received a higher dose than intended.
The report presents the key findings from our inspections of departments, details of our enforcement activity in this area, and provides early feedback on the implementation of the new regulations that came into force in February 2018. It also shares examples of the actions that some providers have taken to improve, which I hope will help you as leaders and healthcare professionals identify where you may be able to make improvements in your own services.
If IR(ME)R applies to you, please take the time to read the report and share within your teams.
Equally Outstanding is an important resource which shows how a focus on equality and human rights can improve care quality — even in times of financial constraint. One year on from its initial launch, we have updated Equally Outstanding with:
- a new e-learning module
- extra case studies from outstanding providers
- an updated PDF, improved based on feedback
The aim of the resources is to help people working in health and social care to learn from providers who have worked on equality and human rights to deliver outstanding care and consider how a focus on equality and human rights can help meet challenges in times of financial constraint.
I would encourage you to take a look at the resources and share them with your equality leads.
We have also published a new resource exploring the use of technology in care. The series will share information on how technology is being used, and will look at what providers will need to consider as they develop new ways of working with technology. The ‘technology in care’ pages currently cover using surveillance in your care service; appropriately handling personal information; and understanding ‘informed consent’.
Visit our website to read more, and you can sign up to receive email alerts when new items are published.
Finally, in previous columns I have discussed the increased pressures faced by providers during winter, and that emergency departments often bear the brunt of this demand. With this in mind, and in line with our current methodology, we will be monitoring trusts and may carry out focused inspections of emergency departments where we deem it necessary. We are hopeful that we will be able to publish these reports in a shorter timeframe to help trusts identify any changes they are able to implement and benefit from quickly. This is also an opportune moment to remind you of our recent reports Sharing best practice from clinical leaders in emergency departments and Under pressure: safely managing increased demand in emergency departments.