Are three-quarters of hospitals in England 'unsafe'?

15 October 2015
What was claimed

Three quarters of hospitals in England are unsafe.

Our verdict

This is the sum of hospitals rated inadequate or requiring improvements in safety by the Care Quality Commission. It doesn't define all these as unsafe. The inspected hospitals aren't known to be representative of all hospitals in England.

"The damning of NHS hospitals: Devastating report reveals 74% are unsafe"

Daily Mail, 15 October 2015

"3 out of 4 [hospitals] are judged 'unsafe'"

The Sun, 15 October 2015

"We are not saying 74% of hospitals are unsafe"

David Behan, Chief Executive, Care Quality Commission, 15 October 2015

Where the bar for safety is set, it seems, isn't the same for everyone. The Care Quality Commission (CQC) confirmed to us that it doesn't consider three-quarters of hospitals to be "unsafe". It also said its findings aren't representative of all hospitals across England, though this wasn't clear from its report.

There's room for interpretation of what counts as 'unsafe': the figure includes hospitals both deemed inadequate for safety and requiring improvement, as opposed to being 'good' or 'outstanding'.

13% of inspected hospitals inadequate, 61% require improvement

Inspecting just under half of acute hospital trusts in England, it found 13% were deemed "inadequate" for safety and another 61% were rated "requires improvement". So 74% in total, as many reports have focused in on.

There were separate findings for GP and adult social care services.

Those aren't all "unsafe" according to the CQC

We invited the CQC to clarify Mr Behan's comments on the BBC Today Programme this morning. It said:

"Our report does not say is that 74% of hospitals are unsafe. What we say is that we rated 13% of hospitals 'Inadequate' for safety—which means that we demanded that they take urgent action to put things right.

"For the 61% of hospitals that we rated 'Requires Improvement' we are saying that they need to do more develop their approach to safety and to prevent things from going wrong—not waiting until they do go wrong. We are not saying that they are 'failing' on safety, but that there is more they could be doing in this area.

The CQC report itself says an inadequate rating is "a strong indication that care is unsafe, or that the organisation does not have the capacity without support to sort out its problems." Here they're talking about failing to investigate incidents properly or learn from them and issues with the number of staff and the training they get. Meanwhile requiring improvement means lacking the high standard of service expected and often needing improvements to systems and processes.

It's fair to say there's room for interpretation on what counts as 'unsafe'. Some might interpret requiring improvement as basically not safe enough anyway. But the CQC itself doesn't say all these hospitals are "unsafe".

Still not representative of all hospitals

We looked at last year's CQC report and delivered a health warning on the reports, quoting the CQC as saying: "This picture is not representative of acute hospitals across England".

That phrase noticeably isn't in this year's report, but the CQC confirmed to us that the same caveat applies and this year's report isn't representative either. It expects to complete inspections of all acute hospital trusts by the end of March next year, and specialist, mental health, community healthcare and ambulance trusts by the end of next June.

So we'll have a clearer picture next year.

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