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Bigger picture: when inspectors call

As many trusts prepare for another round of quality inspection, Janet Youd wants to know if emergency care workers are ready for the truth about their department's achievements.

As many trusts prepare for another round of quality inspection, there is much activity in data collection and a drive to turn action plans from red to green. But a recent presentation by Care Quality Commission (CQC) chief inspector Ted Baker caused me to reflect on the purpose of this activity.


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Do we want to reassure ourselves and others that our service is safe, effective, caring, responsive and well-led, and find evidence to support what we want to believe? Or do we have the integrity to find out the truth, warts and all?

Seeing is believing

Professor Baker insists the CQC would like to see the latter, but it requires remarkable moral courage. In healthcare, we want to believe the service we give is good so we look for the evidence to support that belief. And we sometimes refute evidence suggesting otherwise.

Data exists in abundance. We measure a whole raft of so-called quality indicators and we have natural pride in seeing improvement, accepting the information readily. When the data suggest our performance is below target, we either challenge it or create a colour-coded action plan and identify individuals to make it right again.

Are we ready for the truth?

But aside from reviewing graphs and plans, how do we know whether the safety and effectiveness of our departments is what we would wish it to be? Are we brave enough to seek and report objective evidence? Do we ask patients and frontline staff what care is actually like? And, more importantly, are we ready to hear the truth? If we really want to provide quality care the answer must be ‘yes’.

So, when the inspector calls, we need to be proud of the things we know we do well, but honest about the challenges. Professor Baker suggests this will be interpreted much more favourably than a sea of green action plans, hand-hygiene audits at 100% and a department painted for the inspector’s visit.


About the author

Janet Youd is chair of the RCN Emergency Care Association

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