A joined-up drive on safety

The Independent Healthcare Providers Network recently held a conference on safety. David Hare reports on what changes in regulation the private sector is facing, including a new system of inspection by the Care Quality Commission.

Independent Practitioner Today readers are increasingly aware that the healthcare world is in a period of transition. 

We are moving away from Covid ways of working and back to more ‘normal’ practices and at the same time there is a need to respond to the new changes in the world of healthcare regulation and patient safety. 

Not only is the Care Quality Commission (CQC) implementing a new strategy, the last two years have also seen the publication of numerous reviews into patient safety incidents: from Paterson to Cumberlege to Ockenden. These contain important learnings for providers and practitioners across the healthcare system.  

So we at the Independent Health­care Providers Network (IHPN) were pleased recently to host a joint patient safety conference alongside the CQC – attended by over 100 members – to ensure independent providers and practitioners are fully up to speed with this changing landscape. 

We had a particular focus on how the sector can achieve ‘well-led for safer care’.

Regulatory changes

Kicking off the conference, CQC directors Victoria Vallance and Fiona Allinson gave an overview of the regulatory changes and set out their reflections on what those working in the independent sector should expect in terms of the healthcare watchdog’s new approach. 

While the changes are still in the process of being developed, some of the key areas independent healthcare providers and practitioners should be aware of include:

1Moving away from the CQC’s current three frameworks of registration, health and adult social care to a ‘single assessment framework’ that will be used for assessments of all sectors, service types and at all levels. 

These will be applied from the point of registration through to the ongoing assessment and rating of providers – reducing much of the current duplication.

2Introducing new ‘I statements’ to help encapsulate the views and expectations of patients and the public and make this a clear focus for health and social care providers. 

Likewise, providers will have new ‘we statements’ to help to make clear the expectations on services; for example, ‘we understand our duty to collaborate and work in partnership, so our services work seamlessly for people’.

3Moving away from a separate ‘monitor’, ‘inspect’ and ‘rate’ process and instead making greater use of data and information to analyse and assess providers more frequently. 

The information will come from multiple sources and not just through inspection, with the establishment of a dashboard to help the CQC make better decisions. 

Similarly, CQC reports will be shorter and more accessible to support patients in making the best choices about their care. 

Looking more broadly than the CQC, we were delighted to hold several interactive sessions at the conference, including hearing from the new National Guardian for Freedom to Speak Up, Dr Jayne Chidgey-Clark. 

While there are almost 200 Freedom to Speak up Guardians in the independent sector, not all providers have appointed a guardian and there is significant variation about whether they sit at site level, board level or for clinical vs non-clinical staff. 

Open cultures

Jayne had some fantastic reflections on how those working in the sector can better foster more open cultures in healthcare, including having a clear organisational route for speaking up and for practitioners, to really interrogating the data collected from your guardians. 

This includes looking at whether your organisations have high levels of anonymous ‘speaking up’ cases and what this might be saying – particularly on equality and diversity issues – and ensuring there is a real openness in reporting and discussing the data.

The event was also an opportunity to hear from IHPN members themselves, who deliver both acute and community care, reflecting on their journey to achieving CQC ‘outstanding’ in ‘well led’. 

There is no one-size-fits-all model on this, but key themes cropping up again and again included:

 Organisations meaningfully engaging with you as practitioners at all levels; 

 Empowering you to voice any concerns;

 How services can be improved; 

 Making sure providers have the systems and processes that permit practitioners to be proactive, not reactive, when it comes to safety;

 Having a growth mindset where everyone feels able to question things and explore ‘how might we do this better?’

Improve safety

We had some fantastic speakers including from the GMC, NHS Resolution, Patient Safety Learn­ing, the Healthcare Safety Invest­igation Branch, the Private Healthcare Information Network and CQC, which really helped inform the work we are doing to refresh the IHPN’s Medical Practitioners Assur­ance Framework and help further improve the safety and quality of care independent providers and practitioners deliver to patients.

We finished the day with a sobering session about how we can better engage with patients and staff to improve services. 

Whether it is the Paterson inquiry, Cumberlege report or the recent Ockenden report, too often it is down to patients or relatives themselves to ring the alarm bell when it comes to poor care, with lessons for both providers, practitioners and regulators on how to better engage with patients and families in a more proactive way.

It was fantastic to see so many IHPN members and practitioners working on the ground at the event and it gave both attendees and us much food for thought. 

Perhaps most importantly, however, it signalled just how ambitious and committed all those working in the sector are in striving towards safer care through well-led organisations and all parts of the healthcare system working together to make this happen.

David Hare is the chief executive of the Independent Healthcare Providers Network (IHPN)