Responding to the launch of the new strategy by the Care Quality Commission which outlines its vision for improving the quality of patient care, BMA council chair Dr Chaand Nagpaul, said:

“For a long time the BMA has raised concerns about the way the CQC operates, the negative impact that inspections have on staff and patient services, and ultimately, whether its approach is effective or even counterproductive in achieving its aim, which is about improving patient safety¹.

“Doctors have repeatedly told us how CQC inspections take significant time and resources away from direct patient care²; that they are a poor measure of the quality of care delivered and that the aggregate rating system is crude and unfairly judgemental - failing to take into account the context of individual providers such as workload pressures, staff shortages or extenuating circumstances. The Berwick review³ identified that 'fear is toxic to patient safety' yet CQC inspections instil fear amongst staff and with only a small minority of doctors believing they provide motivation to improve services.

“While this strategy is moving in the right direction, to really improve patient safety CQC must reconsider its crude rating system of inspection – which does not occur in any other UK nation. Instead of instilling fear or blame in staff who are doing their best in a system under pressure the CQC should identify specific areas of improvement and facilitate support for positive change, as occurs in regulatory approaches in many other countries. The CQC must equally recognise that the NHS is vastly understaffed and under-resourced, and inevitably, this has an impact on the care that staff are able to offer patients.

“Disappointingly, there is no mention of staff wellbeing in the strategy, something which is so vital for ensuring high standards of care and retaining the workforce required to meet the growing needs of patients, especially when faced with the record backlog of care that we have now.

“Ultimately patient safety will not be assured by a reliance on episodic CQC inspections, but by a culture of learning, openness and continual quality improvement underpinned by healthcare staff being given the resources and infrastructure needed to deliver the care that patients need.

“Only by recognising and addressing the wider pressures, and the incredibly difficult circumstances doctors and their colleagues find themselves working in, can we make positive changes that benefit patients and staff alike.”

Ends

Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

1. 71% of respondents to the BMA’s member survey in 2018 said CQC inspections add to fear and worrying amongst staff in the workplace, with only 15% of doctors reporting that CQC inspections provide the staff in their organisation with motivation to improve.
2. Meanwhile, 79% of doctors said that inspections divert time and resources away from patient care.
3. Read The Berwick Review into Patient Safety.
4. For media enquiries about the Care Quality Commission, please call the press office on 020 3855 4621 during office hours or email [email protected]