{"id":33204,"date":"2015-01-22T11:39:04","date_gmt":"2015-01-22T10:39:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=33204"},"modified":"2015-01-22T11:57:24","modified_gmt":"2015-01-22T10:57:24","slug":"the-bmj-today-hinchingbrooke-circle-and-tabloid-smears","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/01\/22\/the-bmj-today-hinchingbrooke-circle-and-tabloid-smears\/","title":{"rendered":"The BMJ Today: Hinchingbrooke, Circle, and tabloid smears"},"content":{"rendered":"

\"gareth_iacobucci2\"<\/a>The recent news that England\u2019s first privately run NHS hospital was to be placed into \u201cspecial measures\u201d by healthcare regulator the Care Quality Commission has sparked a fierce and rather ugly political debate.<\/p>\n

As The BMJ<\/em> first reported on 12 January<\/a>, Hinchingbrooke Health Care NHS Trust in Cambridgeshire\u2014managed by Circle Healthcare\u2014was subject to the action after a CQC inspection highlighted serious failings with the hospital\u2019s emergency and medical care services.<\/p>\n

The report was published just hours after Circle announced plans to withdraw from its contract<\/a> to run the hospital after declaring that soaring emergency attendances, funding cuts, and a lack of care in place for patients awaiting discharge had made the contract unviable. The decision was also influenced by what Circle called the \u201cunbalanced\u201d findings of the CQC report.<\/p>\n

Whilst some on the political left say the case demonstrates why the private sector should not run NHS organisations, government supporting newspapers The Sun<\/a>\u00a0<\/em>and the Daily Mail<\/em><\/a> have defended Circle and Hinchingbrooke\u2014and accused the CQC and local commissioners of being involved in a Labour orchestrated plot to discredit the hospital for political gains.<\/p>\n

Matt Limb\u2019s feature for The BMJ<\/em><\/a>, sidesteps the smears in favour of a more considered approach by asking health policy experts to examine the longer term impact of Circle\u2019s withdrawal from Hinchingbrooke.<\/p>\n

In the piece, King\u2019s Fund chief executive Chris Ham tells Limb that he believes the Hinchingbrooke case may spell the end of private sector companies taking on management franchises of NHS organisations. But Nick Bosanquet, professor of health policy at Imperial College London, warns it would be a \u201cgreat mistake\u201d if the case was taken as a warning against all such collaborations in the NHS.<\/p>\n

In a separate head-to-head debate<\/a> also published on thebmj.com, Stephen Collier from the NHS Partners Network argues that the problems at Hinchingbrooke are \u201cnot a reason to decry the role of the independent sector in the NHS.\u201d<\/p>\n

But in the opposing corner, public health doctor Gabriel Scally argues that Hinchingbrooke is \u201ca failed experiment\u201d that proves private providers cannot be trusted to run NHS hospitals.<\/p>\n

In the interest of representing every side of the story, The BMJ<\/em> has also published a letter<\/a> from the consultant doctors of Hinchingbrooke in response to the CQC report.<\/p>\n

Whilst acknowledging that \u201cthere are areas of the hospital that do need improving,\u201d the letter says that the rating was unfair, \u201cAs doctors, it is our professional opinion that Hinchingbrooke provides safe, high-quality care for the vast majority of our patients,\u201d the doctors argue.<\/p>\n

It is true that there are limitations to what a two or three day inspection can reveal about the quality of a service, and it is not easy to convey the nuances of a complex organisation in an inspection report. Circle has signalled its intention to appeal against the findings, and the regulator will decide if there is a case to answer.<\/p>\n

But the tabloid claims of a \u201cstitch up\u201d by the CQC jar with my own recent experience<\/a>\u00a0of shadowing an inspection team in Kettering.<\/p>\n

I observed doctors on the inspection team forensically scanning notes and medical data as well as conducting anecdotal interviews with staff and patients. They were thorough and professional throughout.<\/p>\n

The inspection reports are compiled collaboratively and are typically based on the input of 30 or more people. Whilst the discussions are facilitated by a chair and a lead inspector, reports are produced using input from inspectors, consultants, junior doctors, and patients.<\/p>\n

The chances of one or two people being able to influence the outcome of an inspection to the extent claimed appear to me to be very slim.<\/p>\n

Above all, it is insulting to those involved to dismiss the CQC team\u2019s findings so readily in favour of unsubstantiated innuendo.<\/p>\n

Alas, we may have to get used to these tactics between now and May.<\/p>\n

Gareth Iacobucci<\/strong>\u00a0is news reporter for <\/em>The BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

The recent news that England\u2019s first privately run NHS hospital was to be placed into \u201cspecial measures\u201d by healthcare regulator the Care Quality Commission has sparked a fierce and rather […]<\/p>\n

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