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'Ofsted-style' rating plan for hospitals and care homes

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Jeremy Hunt Kings College Hospital visit 2012
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Health Secretary Jeremy Hunt hopes that a new grading system will incentivise improvement

An "Ofsted-style" ratings system for hospitals and care homes in England has been proposed by Health Secretary Jeremy Hunt.

Recommendations on how the NHS could use a grading system similar to that in schools will be reviewed by think tank the Nuffield Trust.

Currently services have only to meet minimum standards set by the Care Quality Commission (CQC).

Mr Hunt hopes a new system can help end the "crisis of care".

Last week's found services were struggling.

'Tick-box exercise'

The report showed that overall one in four services in England failed at least one of the 16 key standards.

Among the most commonly failed areas were standards relating to dignity and respect, nutrition, and care and welfare.

Critics of the current minimum standards model have said it is a tick-box exercise which does not encourage improvement.

The proposed grading system was announced by Jeremy Hunt in a speech at the King's Fund in London.

Mr Hunt said: ""As an MP I know how well each school in my constituency is doing thanks to independent and thorough Ofsted inspections. But because the CQC only measures whether minimum standards have been reached, I do not know the same about hospitals and care homes.

Star system

"I am not advocating a return to the old 'star ratings' but the principle that there should be an easy-to-understand, independent and expert assessment of how well somewhere is doing relative to its peers must be right."

The CQC previously had a quality grading system called "star ratings" - under this ranking, three stars were given to excellent providers and no stars were for those with poor standards. This system was dropped in July 2010, having been criticised for setting too high a level and not giving an accurate picture of care within a health trust.

An independent study to look at how a new ratings system could work is being led by the healthcare think tank, the Nuffield Trust, which is expected to report back with recommendations by the end of March 2013.

Jennifer Dixon, the director of the Trust said:"It's a sensible question to ask about how the quality of care is assessed in health and social care providers, given all the systems currently in place to boost and monitor quality for the public.

"At the Nuffield Trust we look forward to doing an independent analysis of this issue working with a range of groups across the health and social care world in the UK, learning from past experience , from other sectors, and from other countries."

'True picture'

However, there are warnings that the system needs to be well managed with frequently updated information to work.

David Rogers from the Local Government Association said: "Providing greater clarity would undoubtedly provide much needed assurances for those who are naturally looking for the very best care and support in old age.

"But for a rating to be reliable and trusted it also needs to be current and reflect the true picture of the level of service a care home provides. This means ratings would need to be provided regularly, and certainly be no more than two years old.

"For assessments to reflect a true picture they should also take into account the information that is already available, the views of people who use the service, and information from local authorities and other organisations involved in providing care."

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