Training Primary Care - NHS - GPs - CQC

The latest ‘state of care report’, from the CQC, tells me, and not doubt you, three things.

First, the utter futility of using inspection as a method of maintaining or improving the quality of care. Millions of pounds and years of running under their belt, the CQC gleefully takes to the airwaves to belly-ache…

… some services are nowhere near as good as they should be.

They neglect to highlight, even by the measure of their own unfathomable, made-up standards, most hosptials are actually improving their performance. Despite overwhelming odds.

Inspection is a waste of money. No one serious about quality takes the CQC seriously. They are an encumbrance and a burden. Costly and an impediment.

Rehearsing for the arrival of the CQC costs hospitals millions. The CQC are no more a representation of our services than a Polaroid tells us anything of the thoughts or personality of the smiling people in the picture.

As I wrote last week, the head-honcho-hospital-inspector told a conference that the worst excesses of NHS failures were often hidden from the CQC, for fear of punishment and criticism. I wonder why…

The CQC brings no winds of change, just a whiff of noisome.

We all know what we see. Many of you will know what life is like on the ground, at the front-line, others will know what it is like to manage the tidal-wave of demand with a dwindling workforce.

And, workforce is my second point. Part of Trust’s inability to respond to demand is that there are not enough people to do the job. Simples…

We are waiting for the final ‘people plan’. Based on what we know from the ‘interim people plan’, we should not expect a solution to this problem within reaching distance.

At its heart will be; changing training-curricula, importing staff from overseas, retraining, retaining, returning.. These blindingly obvious conclusions of ‘the plan’ will all require time and money and in some cases changes to regulations.

None of that is achievable within a timescale marked urgent and it is urgent.

Nevertheless, the CQC will continue to belly-ache.

In the meantime, demand will continue to grow… my third issue.

Over the past five years, the 18-week waiting list for planned hospital treatment has gone up from around three million to 4.4 million people. Demand for services at some A&E units has risen by 10 per cent.

The NHS works in the permafrost of perpetual winter.

Demand is fuelled by the near collapse of primary care. People asked to wait a week or more to see a doctor, won’t.

Life isn’t like that anymore.

They’ll go to A&E, where they will be seen, scanned, imaged, sampled, diagnosed, treated and prescribed for, in one visit. In all seriousness, why would you wait.

Nothing our hosptials can do about it, yet the CQC will continue to belly-ache.

Social care is threadbare. A government ragged, frayed and distracted has no solutions. If they did they would have boasted about them by now.

The threshold for entitlement to adult social-care has been raised to the point where it is estimated that around a million older people, who once were supported by care-packages, no longer get any care.

They are refugees in our system and is it any wonder they end up in A&E and is it any wonder we can’t discharge them home, safely.

The CQC will continue to belly-ache.

Our Hosptials deliver services but they are powerless to deliver the solutions to the system’s structural problems.

They are victims of the CQC’s oppression, left to find workarounds for the failure of workforce planning, nigh-on ten yers of flat-line-funding and can only watch as social care is neglected and left to crumble.

The CQC’s belly-aching is misplaced, inappropriate and should be seen for what it is… irrelevant.

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Reproduced at by kind permission of Roy Lilley.