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GPs dodge the spotlight of scrutiny as hospitals face full glare

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The government’s response to the Francis report offered something old: the return of a quality measure with a close resemblance to star ratings; not to mention that old policy perennial, the fast-track management scheme for clinicians and leaders from outside the service.

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‘The area of NHS care which demonstrates as much variability as that of hospital sector will, for the moment, escape full scrutiny’

It also presented something borrowed. In this case the “national barring list for unfit managers” which will be modelled – like an increasing amount of health policy – on a similar scheme operating in education.

But the leadership of NHS hospitals will be concentrating on the “new” – and specifically on the changes to risk management which will be required following the introduction of a more black and white inspection regime, which can tip a provider into failure; sanctions for falsifying data; and the arrival of a duty of candour which might result in criminal prosecution.

A high-profile inspector

Care Quality Commission chair David Prior described the new chief inspector of hospitals to Health Service Journal as having the most high-profile job in the NHS as a result of his or her potential influence on an organisation’s future. Mr Prior also said there were up to 30 trusts which would be likely to attract his or her immediate attention and perhaps the same amount again who would be closely monitored to see if they were improving or not.

Finally, it is worth noting the appointment of a chief inspector of primary care has been kicked into the long grass due to the CQC’s workload and a desire on behalf of the government to avoid further alarming the GP profession. Thus, the area of NHS care which demonstrates as much variability as that of the hospital sector will, for the moment, again escape the full scrutiny its users deserve.

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