Published: 2 November 2022
NHS and social care services are under extreme pressure as we head into what is likely to be an extremely difficult winter. The scale of the challenges ahead cannot be underestimated.
In this highly pressurised environment, CQC has a clear responsibility to ensure that people are receiving safe care. But we also have an important role in helping services to manage the challenges they face by listening to and working with them to offer support wherever possible.
We want to actively encourage innovation. If providers have ideas for new approaches for addressing the challenges they are facing, we want to hear them. We will offer a space to discuss and test ideas against our regulatory expectations. We will have a pragmatic focus on ensuring sustained patient safety in a time of unprecedented challenge.
We want to support providers to:
- keep people safe
- help with implementation of innovative practice
- share innovative ideas more widely if they prove to be effective.
We have worked with CQC’s Emergency Medicine Specialist Advisor Forum to publish two key resources aimed at supporting services and local systems. This forum was set up in 2020. Since then it has provided valuable insight into the reality of delivering frontline urgent and emergency care. The forum consists of senior medical professionals from across the country. They provide specialist advice and see the impact of the current pressures on people and staff every day.
PATIENT FIRST is designed to support those working in urgent and emergency services to ensure safe, effective care. It presents suggested actions that can be taken at a departmental and trust level to:
- maximise capacity
- maintain effective patient flow
- keep staff and patients safe.
A second online tool, PEOPLE FIRST is aimed at Integrated Care System (ICS) leaders and the services within those systems. Offering a whole system perspective, it recognises the urgent and emergency care pathway as a continuum, with solutions required across primary care, secondary care, community care and social care. It highlights good practice and examples of what is working well to support wider learning and improvement.
Designed by clinicians for clinicians, both resources bring together the expertise and situational awareness of those dealing with the reality of current pressures. They offer ideas and guidance to help frontline staff and leaders to deliver safe effective care in the challenging context they are operate in.
Building on that work, CQC’s Emergency Medicine Specialist Advisor Forum is developing a further resource. This aims to help those working in services and local systems to target the priority areas of safety throughout the winter months.
These resources don't have all the answers. But they are practical tools that can be used to guide safe care and to spur innovative practice. We encourage systems and services to consider their application.
As we set out in this year’s State of Care report, solutions to the current gridlock in care can only come from long-term planning and investment. But we also know that embracing and fostering innovation will be essential. Importantly, PATIENT FIRST and PEOPLE FIRST show what can be achieved through different ways of working. They demonstrate how creative ideas can help ensure greater collaboration. This can be both within hospitals and between hospitals and services in the wider community.
We are currently developing our approach to assessing systems and pathways of care. The work we have carried out has helped shape our thinking as we step up the focus on system working over the coming year. This includes:
- looking at provider collaboration during the pandemic
- understanding how local services are working together to deliver urgent and emergency care.
Through our inspections, monitoring and work with providers we see more than ever the formidable efforts clinical staff are making to continue to provide good safe care in an increasingly pressurised environment. We have also seen in many cases, the significant toll that this is taking on them.
We recognise the priority for all providers is to deliver safe, good quality care to people who use their services. As much as possible, we will support providers as they look to innovative solutions and take balanced, risk-based decisions - in partnership with people who use health and social care - to maintain access to services and keep people safe.