An open letter to NHS England & the CQC

An open letter to Sir Simon Stevens, Chief Executive of NHS England (NHSE) and Ian Trenholm, Chief Executive of the Care Quality Commission (CQC).

Dear Sir Simon & Ian,

Following an unannounced inspection by the CQC of five Acute Mental Health Wards of working age adults at Roseberry Park, Cross lane Hospital and West Park Hospital on 20-22nd January 2021, a warning notice under Section 29A of the Health and Social Care Act was issued to Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) after services were found to be inadequate.

When the report was published, it was announced that an external Quality Assurance Board was to be formed to have oversight of the implementation of the action plan to ensure TEWV met its legal obligations and in order for the service to improve. The board was to have representation from NHSE,CQC, local CCG's and TEWV and is chaired by NHSE. 

On learning of the lack of any patient or carer representation on the board, I submitted a request, via the CEO of TEWV, that the board should include appropriate representation of patients and carers in order to ensure both the function of the board, and the oversight of services, included the Experts by Experience, who rely on these services. 

Today I learned that the request has been denied by the joint chairs of the Quality Assurance Board due to the 'difficulties around confidentiality'. I find this response utterly baffling and one which goes against NHS England's own guidance to Patient and Public Involvement. 

 The findings from CQC's study of patient involvement, published in 2016 states that it can be used by providers and commissioners of health and social care to understand what "CQC expects to see when we regulate how well services involve people, to learn from good practice, and to focus on what ‘enables’ people to be involved across the services they use."

During the inspection of the 5 wards in January, according to the report published by CQC on 26th March 2021, the CQC inspection team visited five wards. The team spoke to 23 members of TEWV staff, reviewed 16 patient care records and attended four multi-disciplinary handover meetings. Just two patients were reported to have spoken with the inspectors. 

The inspection team comprised of  two CQC inspectors and was overseen by Brian Cranna, Head of Hospital Inspection at CQC. There appears to have been no lay assessors involved. 

Having personally spent almost ten years working for the National Institute for Mental Health in England (NIMHE) and subsequently the National Mental Health Development Unit (NMHDU) in various knowledge and programme roles, all of which had patient involvement and co production at their very hearts, to discover neither NHSE nor CQC deem input from patients and carers necessary to a critical piece of work to improve services, is nonsensical. In my opinion this decision significantly reduces the credibility of the Quality Assurance Board and suggests a lack of confidence in patient participation.

I urge NHS England and CQC to practice what they preach. To shun the involvement of those accessing the services being overseen by the Quality Assurance Board is a kick in the teeth to those who have the experience, knowledge and skills to assist both the board and TEWV to work together to implement the improvements all stakeholders desperately wish to see.

Your sincerely 

Tony Jameson-Allen FRSA

@TJA_Evonet

mail to tony.jamesonallen@gmail.com