‘We need to act now’: Patient safety at risk as coronavirus set to compound NHS winter crisis, warns hospitals chief inspector

Exclusive: Coronavirus was ‘a wake-up call for society as a whole’ on the importance of social care, says chief inspector

Chief inspector of hospitals warns NHS needs help in wake of coronavirus (AFP/Getty)

The chief inspector of hospitals has warned that patient safety is at risk if the NHS winter crisis is worsened by coronavirus – and ministers must act now in emergency departments to prevent a catastrophe.

Professor Ted Baker, speaking to The Independent in his first interview since the Covid-19 outbreak hit Britain, warned that the NHS could not carry on as before as hospitals across the country struggle to return to normal care while the crisis continues.

“If we are going to do something about it, we need to act now, not at the beginning of winter,” he warned, adding the Care Quality Commission (CQC) was also worried about patients being “forgotten” with NHS waiting lists expected to surge to 10 million later this year.

“We will be going into winter and all the difficulties of the winter viruses that we normally face, together with Covid. I think next winter is going to be very difficult, unless emergency departments and the whole system supporting emergency departments do things very differently.”

After warning earlier this year that poor care in A&E departments was becoming “normalised”, with patients routinely looked after in corridors and experiencing long delays, Prof Baker said hospitals needed to overhaul how they triaged patients and “not using the emergency department as a kind of waiting area for the rest of the hospital”.

“We spent an awful lot of money in developing the Nightingale hospitals ... can we think about investing in the front door of hospitals ready for the winter, so that they are better prepared for the winter crisis?”

He warned providing care in the NHS under the shadow of coronavirus was “a formidable challenge … probably bigger than the challenge we faced at the height of the pandemic”.

Prof Baker also told The Independent that the CQC was investigating a number of reports that some hospital patients were discharged unsafely to care homes following a staggering 55 per cent rise in whistleblowing complaints, particularly in care homes, with 2,612 calls between March and May.

One of the biggest areas of concern throughout the epidemic has been the impact on social care and care homes, where more than 16,000 people have died. A decision in March to discharge thousands of patients from NHS hospitals without routine testing has been a consistent area of criticism for the government.

“It has been raised with us that there were some instances where people believe that people have been discharged from hospital without the proper guidance being followed and therefore, potentially unsafely,” he said.

“If people have breached the regulations by making unsafe discharges we will follow up on that and we’ll take action. But I should emphasise that those are a few cases in a big system where an awful lot of patients have been cared for well.”

The regulator has also been contacted by people worried about patients being detained under the Mental Health Act. Prof Baker said: “That is something we’re very much following up on to make sure that Covid-19 is not leading to more restrictive practices on the ground.”

He said where there had been problems it was often because of a disconnect between organisations.

“It’s a wake-up call for society as a whole. We as a society have not given enough focus to social care and making sure that it is funded properly, but also that there is a sustainable model.

“We’ve got this very artificial distinction between healthcare and social care, which is purely arbitrary. We need to build a continuum between them. Covid has brought that into sharp focus.”

He said it was not for the CQC to suggest solutions, but added: “I would support health and social care being integrated much more closely and breaking down the barriers. If you’re someone using those services, all you see is the barriers between the different parts of the system not providing care for you in a continuous way.”

Prof Baker said it was important lessons were learnt without blame, saying: “This has been a phenomenal challenge, inevitably some things will have not gone as well as we wanted to, we shouldn’t be looking for who to blame we should be asking how can we learn from this so we’re better.

“We haven’t finished this epidemic yet, it’s still going on. We won’t know the full story until we can look back on the full epidemic, and its important people don’t rush to conclusions.”

The CQC is planning to resume routine inspections of hospitals, care homes and GPs from the autumn but will be adapting its approach in light of the risks from Covid-19. It has continued to inspect hospitals and care homes where it has concerns, with more than 30 inspections during the crisis.