Monthly column for providers and professionals working in healthcare from Professor Ted Baker, chief inspector of hospitals.

Winter is often seen as being the most pressurised time for the health and care system, however, services are in fact increasingly experiencing year-round, sustained pressure.

This has been evident in our inspections over the last few months — particularly with the long period of hot weather. The latest combined performance figures from NHS England also point to the impact of the hot weather, showing that July saw the highest number of A&E attendances — an average of 70,000 people being seen a day — as well as growing numbers of patients waiting for routine surgery.

Our inspections and our monitoring of services have shown that while many services are managing these pressures well, they are affecting the safety of care in others. We are concerned that without preparation, next winter could be very difficult for some services. I encourage everyone to review our report, Under pressure: safely managing increased demand in emergency departments, as well as the findings and recommendations from our local system reviews. These do not present quick fixes or simple solutions to what is a complex problem, but they do point to the essential steps hospitals and wider systems need to take to ensure patient safety is protected under the continued pressure that services are experiencing.

Developing a learning culture

Last month, I spoke at the Patient Safety Congress and was impressed by the enthusiasm of everyone there. The very strong theme coming through the event was around the need to address underlying culture issues, focusing on the need for openness transparency and developing a culture that seeks to learn not to blame. This was central to my talk, and was echoed by many others at the congress. There has been a great deal of negative coverage of the NHS safety culture recently, but we are finding a much more mixed picture through our engagement with providers, and we know that good leadership can build safer systems.

A new approach to coproduction

Finally, I wanted to thank those who attended our first ever cross-sector coproduction event last month. At CQC we use coproduction to develop our policies and approach. Many of you will be aware of our regular coproduction groups for adult social care, primary care, and healthcare, but we wanted to test a new approach and bring people together from across health and social care to discuss some of the big issues affecting the whole sector.

Topics discussed included the findings from our reviews of local systems; how CQC manages its relationships with different stakeholders; proposals for changing how we structure our register of services; and how we can evolve our coproduction approach to make it more effective and inclusive.

Many thanks to Amanda Stanford, Deputy Chief Inspector of Hospitals; Andrea Sutcliffe, Chief Inspector of Adult Social Care, and Prof Steve Field, Chief Inspector of General Practice for their excellent chairing of the day.

You can read Andrea Sutcliffe’s blog for more on what happened on the day, and below you can see mine and Amanda’s commitments to using coproduction to help improve the quality for everyone who uses health and social care services.

Prof Ted Baker’s coproduction commitment: To make sure we listen and learn from the wisdom of our colleagues
Amanda Stanford’s coproduction commitment: To work collaboratively with colleagues across CQC and externally to drive improvements for the benefit of patients and service users

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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