Health Services: Standards

(asked on 10th June 2019) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance NHS England has given to (a) clinical commissioning groups and (b) other NHS bodies on moving patients in NHS commissioned placements when the setting they are in receives a rating of Inadequate from the Care Quality Commission.


Answered by
Caroline Dinenage Portrait
Caroline Dinenage
This question was answered on 13th June 2019

In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.

The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.

The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.

Year

Commissioned Placements

2016/17

4,530

2017/18

4,604

2018/19

4,635

Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.

There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.

As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.

As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.

If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:

https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf

https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf

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