Children in hospital to get greater voice in health service inspections

The move follows a report by Sheila Shirbman, who was asked by the inspectorate to look at how it inspects hospital services for children.

Of the 73 recommendations for improvement made, the inspectorate has accepted or partially accepted 70 and has deferred making a decision on the remaining three.

Among changes the CQC has pledged to make is to ensure a minimum of two parents are included in inspection teams looking at specialist children’s trusts.

The CQC has also accepted Shribman’s call for children and parents on wards at the time of inspections to be interviewed.

Other changes to be made also include appointing a dedicated children and young people’s deputy chief inspector within its hospital inspection team. This new role will be supported by three national professional advisers: a paediatrician, a children’s nurse and a children’s mental health care expert.

Shribman, who is former national clinical director for children, young people and maternity care at the Department of Health, said: “CQC’s new approach to inspection provides a real opportunity to drive up the standard of care for children and young people and reduce unacceptable variations. ?

“To do this CQC must get its inspection model right. My report sets out how CQC can begin to achieve this. It was a pragmatic report, focusing on what CQC can realistically be expected to deliver.”

In its response the CQC says some of the recommendations have already been tested in two pilot inspections this year, taking place at Sheffield and Alder Hey hospitals. This included the recruitment of parents to take part in inspections.

Chief inspector for hospitals Professor Sir Mike Richards said of Shriman’s report: “Her recommendations make sense and we are accepting in whole or in part almost all of them. They will go a long way to ensuring that our inspections of services for children and young people are appropriate and command the confidence of those working in this field.”
 
He added that deputy chief inspector Professor Ted Baker has been appointed to take the lead on children and young people’s hospital inspections.

Of the three deferred decisions two relate to improvements to inspections of tertiary services such as orthopaedics and cancer. The CQC said it did not currently have the capacity to carry this out, but would review this decision in January 2016.

Shribman also called for children’s hospices to be inspected by the chief inspectors of either general practice or hospitals. Currently, they are inspected by adult social care inspection teams but this will also be reviewed in January 2016.

Her report also highlights evidence from 2012 by the Children and Young People’s Health Outcomes Forum that found around a quarter of child deaths in hospital showed an “identifiable failure in the child’s direct care”. In 43 per cent of deaths there were “potentially avoidable factors”.