BMJ 2015;350:h636 doi: 10.1136/bmj.h636 (Published 3 February 2015)

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NEWS CQC defends rating of Hinchingbrooke as “inadequate” Matthew Limb London

MPs have asked for more evidence to resolve a dispute over the care quality rating of “inadequate” conferred on a privately run NHS hospital. Hinchingbrooke Health Care NHS Trust, which is managed under contract by the private firm Circle, was heavily criticised in a recent report by the Care Quality Commission.1 2 But the trust’s chief executive, Hisham Abdel-Rahman, told the House of Commons Committee of Public Accounts on 2 February that the report was “problematic” and contained many errors.

He said, “We sent them [the CQC] 300 factual inaccuracies. They agreed with 65% of those, but despite that they did not change the rating.” He said that there were “good explanations” for some of the incidents seen by the CQC during its inspections, but the regulator failed to provide the trust with enough notes and facts to investigate further. The committee member Stewart Jackson, the Conservative MP for Peterborough, told the CQC’s chief executive, David Behan, that he should be “ashamed” of the inaccuracies. Jackson accused the regulator of “used car salesmanship,” “traducing” the hospital’s reputation, and he questioned the organisation’s fitness to judge. He asked for a full breakdown of the “errors” to be submitted to the committee. He said, “We need to know whether this was a well researched, fact based report rather than a farrago of sloppy unprofessional anecdotes and innuendo.” The committee’s chair, Margaret Hodge, the Labour MP for Barking, also asked the trust to submit its list of alleged errors to the committee.

Behan said that some of the “errors” were spelling mistakes that had been corrected. He said he stood by the CQC’s findings and defended the probity of the inspection process, which had led to the hospital being placed in special measures. He told MPs, “We did not expect to find what we found when we went into Hinchingbrooke. But the fact is those patients and those staff did indeed speak to us and raise those concerns.” Challenged on a finding in the CQC’s report that some patients were told to soil themselves, Behan said that this was a “fact”

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reported to the inspection team. Jackson said, “It is not a fact; it’s an anecdote that you’ve not been able to prove.” Behan said, “We found what we found. We’ve set that out and reported that in a public and transparent way.”

In heated exchanges Jackson also challenged Behan over the CQC’s intelligence monitoring systems, saying that these rated the hospital in the “lowest band of risk” four months before it judged the trust “one of the worst it had seen.” Behan said that the intelligence monitoring was just one tool to inform decisions about inspection and not of itself a judgment on quality and safety. He said that the CQC found a range of concerns, covering care, hand hygiene, infection control, pressure control, and catheter control. He said that CQC inspectors had visited the trust again on 2 January to carry out a review and that a new report was being written. “There have been improvements made,” he said. “[On] a lot of the issues—practical issues we have identified—action has been taken. A lot of those things we wanted to see improved quickly are beginning now to be put in place.” Jackson also asked whether members of the CQC’s inspection team at Hinchingbrooke Hospital may have had potential conflicts of interest because of their political affiliations and an “axe to grind.” Behan replied that CQC’s track record showed it was not biased against the private sector but that it had amended its conflict of interest declaration form to ask people about wider declarations they ought to make. Steve Melton, Circle’s chief executive, said that the CQC report’s criticisms were not a factor in its decision announced in January 2015 to pull out of the contract.3 1 2 3

Iacobucci G. Privately run trust is first in England to be rated “inadequate” on patient care. BMJ 2015;350:h179. Care Quality Commission. Hinchingbrooke Health Care NHS Trust: quality report. www. Iacobucci G. Private company says it can no longer run NHS hospital. BMJ 2015;350:h159.

Cite this as: BMJ 2015;350:h636 © BMJ Publishing Group Ltd 2015


CQC defends rating of Hinchingbrooke as "inadequate".

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