Stronger inspection role for health watchdog supported by poll of nurses

The health regulator the Care Quality Commission (CQC) needs to be strengthened to protect NHS whistleblowers and staffing levels, a union has said.

A poll for the Royal College of Nursing (RCN) found its members supported the role of the CQC but believe it needs to improve.

It is recommending a series of measures, including that the CQC sets a two-week target for responding to NHS staff who raise concerns about standards in their workplace.

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The regulator should also monitor and publish its success in meeting those targets and, if it cannot meet them, must look again at whether more staff are needed.

The CQC has come in for heavy criticism in recent months, including over missed deadlines for registering health and social care providers and falling numbers of inspections.

More than one in three nurses surveyed by the RCN (35 per cent) said they did not believe the CQC sufficiently takes into account the importance of staffing levels on NHS wards, or the skills mix of staff.

The RCN has repeatedly raised concerns about low staffing levels contributing to poor patient care, and how trusts have changed the skills mix between numbers of fully qualified and unqualified staff.

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Many nurses in the survey also had concerns about the consistency of inspections across England, the RCN said.

RCN chief executive Dr Peter Carter said: “Having the right numbers and mix of healthcare professionals is pivotal to delivering high standards of patient care and outcomes.

“It is therefore very worrying that nurses feel that the CQC does not focus enough on staffing levels in hospitals and care homes, and has a lack of experienced staff to carry out the inspections. This clearly undermines the credibility of its work.”

The RCN wants the CQC to report specifically on staffing levels during its inspections, including the ratio of registered nurses to other staff.

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It should also develop an appropriate tool to determine staffing levels and nurse-to-patient ratios, it said.

Furthermore, the CQC should also ensure all providers have an unannounced inspection once a year and inspectors should speak to staff – both junior and senior – without managers present so staff can speak freely.

Dr Carter said: “There is no doubt that nurses and healthcare assistants support the need for an effective regulator.”