Hospitals fall foul of new NHS licensing system

The Care Quality Commission (CQC) has granted 66 licences under a new registrations system which permits NHS trusts to provide services.

But it warned "further urgent improvements" are needed at the Mid Staffordshire and Milton Keynes trusts.

Both have come under scrutiny over the safety and quality of care they offer.

The remaining 64 organisations, including five hospital trusts, four primary care trusts and one mental health trust in Yorkshire, can operate without terms on their licence in the first of three waves of registrations over the next fortnight.

All 381 NHS trusts in England must be registered with the CQC by April 1.

If trusts fail to meet standards, the CQC has stronger enforcement powers than before, including being able to give warning notices and fines.

The regulator will also be able to prosecute trusts, close them down or restrict their activities.

CQC bosses plan to make their checks "real-time" to answer critics who say regulators have responded too slowly in the past. Patient views will also be given greater weight and they will also be involved in inspections.

Cynthia Bower, chief executive of the CQC, said: "This is a tough new system and we have stronger enforcement powers than ever before to make sure services improve.

"We are moving to a system where we will be looking at whether trusts are meeting the standards today and tomorrow rather than in the past.

"We hope to identify and tackle problems earlier. If at any stage we believe a trust needs to take further action to protect patients, we will ensure this happens using our enforcement powers where necessary.

"For a number of trusts registration will be conditional on them taking immediate action to improve. Others have identified specific areas they say they are addressing.

"We will be keeping a very close eye on them to make sure they do. Safety is our number one concern here."

An independent inquiry into Mid Staffordshire found it "routinely neglected" patients and displayed "systemic failings".

The investigation was launched after a report revealed appalling standards put patients at risk and between 400 and 1,200 more people died than would have been expected between 2005 and 2008.

Today's CQC assessment shows Mid Staffordshire is non-compliant with six of 16 essential standards of safety and quality.

The CQC said the trust was not implementing a new policy relating to moving patients from A&E to wards quickly enough.

Other areas of non-compliance relate to supervising and assessing staff, maintaining equipment, ensuring staff have the training they need, and poor handling of patient complaints.

Earlier this month, it was announced an expert team was being sent in to improve a failing maternity unit in Milton Keynes.

The CQC has said it must take urgent steps to recruit more midwives and improve planning for periods of high demand and emergencies.

It has failed to comply with four of the 16 essential standards including not having enough midwives and not having enough cover to monitor at-risk mothers and babies.

CQC regional director Roxy Boyce said the trust had been told it must give women in labour one-to-one midwife support. Such conditions have not been imposed on other trusts.

She said: "We have imposed a number of conditions requiring action to ensure the safety of mothers and babies.

"Until all of these issues have been fully addressed, we are making it a legal requirement for this trust that all women in established labour receive one-to-one care from a registered midwife."