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The Uk's Healthcare Law Service
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David
Behan talks about the "Myths" surounding new proposed inspection
processess
CSCI.
Myth
1 - It will mean only inspecting every 3 years. This is not the case. The simple
tick-box approach of doing two Inspections every year for every provider is no
longer good enough. It also makes sense to have a 'lighter touch' approach for
the best providers. I choose the term 'lighter touch' with care and
deliberation. While the frequency of inspections may be reduced, we are not
talking about zero contact between one inspection and the next or less rigour in
the way we scrutinise services. Our new system is based on the premise of
proportionate, risk based regulation.
There will be an annual assessment. We will undertake a number of
"themed" inspections. We could do one on medicines or food or dementia
mapping. One of the issues about concentrating our major effort on those needing
most improvement, is that we rarely get to see and promote good practice. By
doing themed inspections we can learn about particular issues and understand how
parts of the sector have developed positive ways of resolving them.
The 'every three years' assumption is wide of the mark. I hope we can continue
to get this point across, because it is an important one.
Myth 2 - It will lead to more inconsistency in judgements than under the
previous system. What we are looking for is consistency of judgement.
Judgements based on the evidence of what is effective in meeting the needs of
people. Consistency is not the same as uniformity. The criticism of the current
system, by those of you who run services and by many Inspectors is that the tick
box approach does not focus on outcomes, but also that it is driven by a desire
for uniformity. We want Inspectors to judge the quality of the services they
inspect using their professional knowledge and the evidence of what works. The
evidence is that inconsistency is reducing.
Only this week I received a letter for a provider in the Midlands whose services
were inspected by a number of inspectors who was commenting that variations
between services were diminishing. He carries out a regular analysis of
inspection reports and has shared the outcome with us. There is an critical
issue here which is the role of managers in driving consistency in practice and
outcomes. Where there is high staff turnover, where there is turnover of
managers, then these are the pre-conditions for inconsistency. For our part we
will continue to ensure we have policies which we will implement clearly and
consistently.
An example is the work we have recently completed on enforcement. We will also
continue to ensure we attend to the development of staff to ensure they have the
skills, knowledge and competence to complete the work we are asking of them. We
will support our people in bringing about the required culture change.
What will success look like?
We will have moved to a culture of improvement not compliance
Service users will have better services and feel more able to influence their
services
Innovation will be rewarded and encouraged
The sector will grow to meet increasing and changing demands
People will be able to plan their own services using CSCI to support their
decisions.
A number of our proposals that people liked most need a change in the
regulations or the national minimum standards. A review of these is currently
being led by the Department of Health and Department for Education and Skills.
Consultation by the Department of Health is currently underway. CSCI will work
closely with Ministers to refine the existing way of describing and measuring
the quality of services.
Conclusion
The Green Paper and the forthcoming White Paper lays down the challenge of
delivering personalised services which put people at the centre;
Excellence in services will be achieved through really listening to people who
use services; by investing in staff learning and development; through high
quality leadership and through performance management which is embedded in the
way organisations operate.
Our plans to modernise regulation will support improvement; they reflect what
people have told us they want to see; and we feel meet the challenges for
inspectorates set down by the developing policy agenda.
We have the potential to the meet the challenges - commissioners, providers and
inspection - and I believe we will. I don't underestimate the challenge of
achieving the necessary change - it requires us all to work together in
alliances as partners to make this work. However we need to rise to this
challenge - the prize of truly people-centred services is worth it.
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