CQC

Not wrong

As much as they try, the family of Ruth Perry, the headteacher who in the shadow of an Ofsted inspection, took her own life, won’t be able to fill the empty chair, this Christmas.

The needless, obscene waste of a beautiful young life, stolen by the brutality of senseless, thuggish inspection.

Condensing and condemning the work, effort and aspirations of scores of people, into a single brutal word.

Berkshire’s Coroner, said; Perry’s suicide was ‘contributed to by an Ofsted inspection…’

Contributed to?

No… in my unshakable view, ‘wholly responsible for’… is closer to the truth.

Without the anxiety, the potential for reputational damage to the school, children and parents she served, would Ruth Perry have ever contemplated suicide?

Of course not.

She died because she was sick with worry, caused by clumsy, cack-handed Ofsted.

I’ve never met Ruth Perry but over the years, I have met people just like her.

Wonderful people, committed to doing the best they can for their organisations and the people they serve.

My time as a school governor qualified me to recognise devotion when I saw it.

My time around the NHS more than qualifies me to say I’ve met plenty of people, just like Ruth Perry; highly trained, experienced, hearts full of joy, love and commitment, to do the best they can with what they’ve got.

Ofsted boss, Amanda Spielman delivered a mealy-mouthed apology for the ‘distress the inspection had caused her’.

Spielman has never taught a class of children and seems to have no concept of what damage ham-fisted inspection does.

Spielman was appointed in 2016, her nomination first rejected by the Education Select Committee… citing her lack of teaching experience, failure to show ‘passion’ and lack of understanding for the ‘complex role’. She was appointed, nonetheless.

The guru-godfather Edwards Deming, denounced inspection in the third of his 14 Points of Management;

‘Cease dependence on inspection to achieve quality. Eliminate the need for inspection on a mass basis, by building-in quality… in the first place.’

Inspection doesn’t work…

• Turn-up and it’s good, you’ve wasted your time.
• Turn-up and it’s bad, you’re too late.

The damage the threat of and outcome of, inspection can do, is obvious.

Whilst nothing as awful has yet happened in healthcare I can tell you how inspection can drive even seasoned managers, to the edge. I know, I’ve spoken with them. And, some who’ve left.

Let’s not forget; Five doctors died by suicide while under GMC investigation between 2018 and 2020.

People care about what they do. They do not care for blunderbuss systems and clunky people distilling the work of thousands into a single word.

How does denouncing an entire organisation as ‘requires improvement’ or ‘inadequate’ impact hundreds of sharp-end-staff, who;

• work ‘till they drop,
• have no influence over how the organisation is run,
• staffing numbers,
• for the quality of work in other departments or specialties,
• shortage of beds,
• the absence of social care
• the failings of a bone-headed board…

…. and let’s not overlook the impact on recruitment.

It’s like branding an entire family as ‘criminal’ because a second cousin’s been caught fare-dodging.

There are structural fault-lines across the NHS; staffing, money, capacity and neglect.

The CQC can’t fix any of the root-causes of organisational short comings but they can make the situation a whole lot worse.

They’re a colossal waste of time and our money. Big money. Their budget has grown to £207m. They’ve been going since 2009. Fag-packet numbers?

That might mean £3,000,000,000 down the drain. For what?

• In 2015 the PAC raised concerns over the performance and ability of the CQC. This followed criticism three years earlier; concerns over governance, leadership, culture and failure to intervene… in failing healthcare services

• In 2017 the Burton Report said; the CQC ‘places inappropriate burdens onto a struggling system’.

• In 2018 the Kings Fund; little evidence of patients exercising choice in response to ratings. Receipt of an ‘inadequate’ rating … [has]… little measurable impact on … service volumes… and … performance indicators.

• In 2020 the EHRC’s damning report on home-care services… ‘confirmed… the industry’s regulator, the CQC, has again been caught on the back foot’.

• Just this week; CQC… apologised for failing to act promptly on whistleblowing concerns at Cambridgeshire and Peterborough FT… tampering with a patient’s record after they’d died by suicide.

Over the years, a succession of CQC boards and changes in approach have failed to impact NHS quality.

It can’t and won’t. Inspection does not work. End-of.

Last month, analysis by the Guardian newspaper revealed more than half of Trusts were CQC rated as substandard.

Nothing is getting any better. In fact, it’s worse.

Inspection is pernicious. Does more harm than good, costs a fortune.

The CQC, Ofsted and people who want to be ‘inspectors’ do not understand the difference between quality assurance and quality control, neither do they grasp the difference between improving performance through boosting morale and a mugging.

Inspectors can have no ownership in the impact of the outcome. They kick down doors, move on… leaving them swinging in the wind.

As a career, would you rather find the best and share it or dig out the worst and use it to demotivate and demoralise people who don’t deserve it and can change nothing?

Back to Deming.

His Number 8;

Drive out fear, so that everyone may work effectively for the organisation.

He’s not wrong.

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.