New system of registration does not let boards off the hook

After just a year in existence, the Care Quality Commission has fulfilled its promise to register all 378 NHS trusts in England that provide health care services. It was no mean feat to achieve this in such a short timescale.

Given the potential implications of not being registered, ie, being prohibiting from providing health care services, it is hardly surprising that all NHS providers have in fact been registered. Careful attention will need to be paid to those trusts that have been registered with conditions to ensure that these concerns are speedily rectified.

The overriding duty of the CQC is to identify where minimum standards are, or are not, being met so that the public can be confident in the quality of health services wherever they access them.

The challenges posed by the current economic situation mean that trusts may be tempted to take short-term decisions that are detrimental to quality. The CQC will have to ensure that its monitoring and risk-profiling processes are sufficiently robust to guard against that.

Information is critical; the challenge is to ensure that robust information is in place to allow risks to be spotted and acted on – nobody wants to see an inspector in every hospital corridor. The CQC will need to make careful use of its new powers to act on concerns so that members of the public can feel assured that their health care provider is providing safe and good quality services.

But however effective the regulator, it will never be able to continuously examine every organisation in detail. The ultimate responsibility to ensure standards are maintained rests firmly with the board of each organisation.

It is essential that boards have systems in place to monitor routinely the quality of care provided (as well as keeping an eye on the finances), and that there are simple procedures to allow staff, patients and the public to escalate concerns.

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