HSJ reported last week upon CQC having taken enforcement action against an NHS Trust by the issue of a Warning Notice.
A Warning Notice is a step which records that the regulator believes that evidence to the criminal standard (beyond reasonable doubt) is established which justifies the prosecution of the provider (in this case a major Hospital Trust), but, that in the circumstances the CQC will not prosecute on this occasion but rather publish their findings in the form of a warning.
This should never be used as a low level injunction to improve operations. The Notice should never be based on speculative opinion but should reflect hard and sustainable evidence.
It is worrying that the CQC too frequently take this step without any reliance on firm evidence but rather as a moderate admonishment to what CQC sees as poor performance rather than stigmatised as failing and placing patients at risk without either real evidence, or, any effective method of appeal. In these cases CQC is usually seen to mark its own homework, often by the very inspector who made the allegation. In this case CQC are reported to have said: –
“it is also clear that there are several factors within the local health and social care system that are impacting on this trust from improving….There are blockages within the system….especially when it comes to discharging people who no longer need acute care….the trust….cannot solve this problem alone…”
Given the observations it is difficult to see how the Trust can be said to have committed an egregious breach of regulation which justified prosecution.
The public will be alarmed and not comforted and this may cause quite disproportionate distress.
Such “enforcement” activity against similar backgrounds is by no means uncommon. CQC needs to reflect whether publicising alarmist statements serves the interest of the general public who the CQC was established to protect.
As such it may be described as high level “fake news” which should not be disseminated in the name of regulation.
