YET ANOTHER REGULATOR TO MONITOR CARE HOMES AND TRUSTS

Under performing NHS Trusts and Care Homes face fines closure under powers for a new health and social care watchdog, a leaked government document suggests.

According to the document a new regulator to be known as Ofcare will replace the bodies that monitor hospitals, care homes and mental health trusts. It will be the fourth regulator of social care in as many years and the third significant shake-up of healthcare inspections in a decade.

The Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission will be replaced by the body by April 2009. It will be able to charge trusts a registration fee for the purpose of being inspected.

The leaked document, reported today in Health Service Journal, is a draft of the latest plans by the Department of Health to create a “super-regulator” to supplant the existing watchdogs.. Ofcare, which stands for the Office of Health and Adult Social Care, will be responsible for the quality and safety of services and will be able to impose fines on organisations that do not meet national standards.

The watchdog could instigate a statuary warning notice demanding improvements, issue a formal caution or a temporary suspension of registration, impose conditions restricting what can be provided, or start a criminal prosecution.

The document is the result of a consultation on proposals that were published in November. The current procedure, under which the Healthcare Commission places failing trusts under “special measures”, will be abandoned.

Strategic health authorities and the Department of Health will retain responsibility for assessing the financial performance of NHS trusts, and the independent Body monitor will inspect the financial performance of foundation trusts.

The document says that Ofcare will have “broad powers of intervention [and] discretion about how and when to use them”. It emphasised that Ofcare would not be responsible for choosing how improvements were made, and added that in most cases providers should be able to recover and maintain services.

Where an organisation is shut down, local health authorities will be responsible for ensuring continuity of care – but Ofcare will have to “consider the balance of risk” on how this will affect patients. Providers will be able to appeal against decisions to the Care Standards Tribunal.

Health service managers said yesterday that the prospect of fines for poor performance, which could exacerbate deficits in some NHS trusts, was too strict. Nigel Edwards, policy director of the NHS Confederation, said: “We want to avoid making fining people a frequent part of regulation as it is somewhat against the prevailing culture of healthcare.

The Department of Health said last night that it would not comment on the contents of a leaked document. “We expect to publish our response to the consultation shortly, in the next month or so,” a spokesman said.

June 2007