NHS Trusts: One In Four Labelled 'High Risk'

More than a quarter hospitals may be failing to provide safe, good-quality care for patients, health inspectors have warned.

The Care Quality Commission (CQC) has identified 44 NHS trusts as at risk based on a new assessment system that includes higher-than-expected death rates.

They include some of the best-known trusts in the country, including Alder Hey Children's Hospital, which said it was "extremely disappointed and surprised" to have been included in the CQC's list.

The CQC devised an "intelligent-monitoring system", which scans hospitals on 150 different measures, including staff and patient satisfaction, whistle-blowing and infection rates.

Those with the most serious concerns are then prioritised for scrutiny by a team led by the new Chief Inspector for Hospitals, Professor Sir Mike Richards.

Prof Richards said: "As a doctor, I liken intelligent monitoring to a screening test; our inspection combined with intelligent monitoring provides the diagnosis, following which we make a judgement, which will in turn lead to action.

"Our intelligent monitoring helps to give us a good picture of risk within trusts."

The new monitoring system was devised in the wake of a report by the NHS medical director earlier this year.

Eleven hospitals were put in special measures as a result of Professor Sir Bruce Keogh's report, some of which had passed earlier CQC inspections.

The first scan of all 161 acute hospital trusts in England has resulted in 24 being put in the top band, with another 20 in the second band.

A Department of Health Spokesperson said: "Following the Francis Inquiry the CQC has introduced radical changes to hospital inspections, with a new Chief Inspector, Sir Mike Richards, leading significantly larger inspection teams which are headed up by clinical and other experts. This next step will help to give the CQC a good picture of risk within trusts.

"Patient safety should be the first in everything the NHS does and we expect the CQC to act where it finds failings of care."

Health Secretary Jeremy Hunt said: "The CQC's new tough and transparent approach to hospital standards is exactly what our NHS needs. There have been big variations in hospital quality for many years."

Dr Jennifer Dixon, chief executive of the Health Foundation and a CQC board member, said: "It makes sense to use the wealth of routinely available data in the NHS to try to spot patterns which might identify or predict poor-quality care for patients.

"The intelligent monitoring tool can never by itself be a crystal ball, but it is a great start and will surely develop over time."

Alder Hey Children's NHS Foundation Trust Chair Sir David Henshaw and Chief Executive Louise Shepherd said: "We believe that the information published today is inaccurate and misleading, and we are seeking urgent clarification from the CQC."

The trust said an inspection by the CQC in January 2013 found it to be "fully compliant" and the report raises no issues with patient safety or the quality of care.

Commenting on the data, the Royal College of Nursing (RCN) said there was a strong link between low staffing levels and hospitals on the brink of crisis.

Dr Peter Carter, Chief Executive & General Secretary of the RCN said: "The measures the CQC are using should enable them to track these problems and ensure that services are safely staffed for the level of patient demand."

Meanwhile, it has been announced that NHS Direct in England is to close at the end of the financial year.

The service said in July it was pulling out of contracts to provide the 111 non-emergency number service due to financial problems.