Press release

Hunt orders review into OFSTED style ratings for NHS and social care

Study to help end the ‘crisis in standards of care’ that exists in parts of health and social care

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Health Secretary Jeremy Hunt today ordered a review to assess the merits of an ‘OFSTED style’ system of ratings for hospitals and care homes.

The review will look at the way in which a new ratings system could help end the ‘crisis in standards of care’ that exists in parts of the health and social care system.  It will look in particular at how information about services can be communicated to the public and how this information can be used to drive up standards across the system.

He condemned the examples of poor care that have surfaced in the past - such as patients being left to lie in their own excrement in Stafford Hospital, and residents being kicked, punched and forced into cold showers at Winterbourne View.

In describing these cases, Health Secretary Jeremy Hunt said:

“In places that should be devoted to patients, where compassion should be uppermost, we find it’s the very opposite; a coldness, resentment, indifference, even contempt. Go deeper, and look at the worst cases - like Mid-Staffs and Winterbourne View - then there is something even darker. The normalisation of cruelty, where the unacceptable is legitimised and the callous becomes mundane.”

He made clear that dignity, respect, and a constant, relentless drive for improvement in standards of care must be paramount. Greater transparency about how institutions perform is essential to that - starting with the ‘friends and family test’, which will be rolled out across the NHS.

Jeremy Hunt continued:

“Next year we will roll out the “friends and family” test across the NHS.  For the first time hospital users will be asked if they would recommend the care they received to a friend or close member of their family.  NHS staff will also be asked anonymously whether they would recommend their organisation to their own families.

“That’s the closest measure we can get to “care as you would wish to be cared for”. And we will publish the results.  But we need to do more.

“As an MP I know how well each school in my constituency is doing thanks to independent and thorough OFSTED inspections. But because the CQC only measures whether minimum standards have been reached, I do not know the same about hospitals and care homes.”

“I am not advocating a return to the old ‘star ratings’ - but the principle that there should be an easy to understand, independent and expert assessment of how well somewhere is doing relative to its peers must be right.”

“So this week I have asked for an independent study to be done as to how this might be achieved in a way that does not increase bureaucracy.”

Secretary of State has asked for recommendations by the end of March 2013. He has been clear that, whatever the recommendations are from the review, any proposed new ratings system should have;

  • no increase in bureaucracy;
  • clear, simple results that patients and the public can understand - driving organisations to excel rather than just cover the basics; and
  • greater certainty that poor care is identified early.

Jennifer Dixon, Director of the Nuffield Trust will lead the review.  She said:

“It’s a sensible question to ask about how the quality of care is assessed in health and social care providers, given all the systems currently in place to boost and monitor quality for the public. 

“At the Nuffield Trust we look forward to doing an independent analysis of this issue working with a range of groups across the health and social care world in theUK, learning from past experience, from other sectors, and from other countries.”

Jeremy Hunt also made clear that stronger managerial accountability from managers needs to be strengthened. When we publish our response to Winterbourne View we will set out in detail how we intend to achieve this.

The objectives of the review are; 

  • to map the current system of assessing the quality and safety of care of providers of health and social care and the current system of accountability for quality of care;
  • to identify the advantages and disadvantages of assessing providers of health and social care;
  • to identify in broad terms how best to combine relevant current and historic data on quality (safety, effectiveness, and user experience) and information from inspection to provide a useful, credible and meaningful assessment for comparing the  performance of organisations providing health care and social care;
  • key goals will be to use existing metrics, rather than require costly new data collection, and not to create extra burdens on providers;
  • to suggest priorities for developing data and testing metrics in the short to medium term to allow better comparative assessment; and
  • to identify which organisation/s might be best placed to provide such assessments.

**Notes to Editors **

For more information speak to the Department of Health press office on 0207 210 5707.

The full terms of reference of the review can be found from the news story on the Department of Health website.

Published 28 November 2012