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Hello, my name's James Titcombe and I am the National Patient Safety Advisor for CQC.
And I'm really pleased today to be answering some of your Twitter questions.
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Yeah absolutely, so the whistleblowing event was a really good start
and enabled us to really understand some of the stories that people have had
and some of them are quite shocking.
We're doing a lot of work in complaints as well, we're working with the Patients Association.
It's so important that organisations respond and learn from the complaints it gets.
And we've got a big role to play and we've got to get that right.
So absolutely, in the future we will be having a listening event to talk to complainants
about the work we're doing and to get their views on the direction we're going in.
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Really good question, I don't really consider myself a whistleblower at all to be honest.
I'm a dad who had a tragic incident in the NHS and I've responded to it.
So that doesn't really make me a whistleblower,
I've got more respect I think for professionals who have raised concerns.
So the question I think is also making a point - where does the information that
historical whistleblowers tell us fit into CQC?
And it's really important to say that we do need to listen to people's historical experience.
It's about the culture of the organisation, how they were treated,
and we need to know that an organisation is treating people properly.
So we do need to listen and we do need to learn from that experience.
In terms of what we do in our inspections at the moment, obviously the focus
has to be on current standards of care so if something happened 5, 6, years ago
that isn't going to be as relevant to us in terms of inspections
but we do need to know about historical whistleblowers, we do need to listen and
and we do need to make sure the culture changes in those organisations.
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The Don Berwick report talked of, more than anything, the NHS needs to become
an organisation of continuous learning.
And I think if we look back at what Francis said
a lot of his findings were about the lack of candour, about defensive cultures, a cover up culture.
That's really what we've got to change and to get that right you've got to
have the right kind of culture, you've got to have good leadership, staff who feel able to talk about things
that have gone wrong, you've got to have an open reporting culture.
So to get that right it's got to take leadership, and this idea of a blame culture has got to change.
We've got to have people safely able to report things that have gone wrong and for
learning to be the number one response to incidents, not defensiveness,
learning to be the number one response to incidents, not defensiveness,
not covering up and that's really where we've got to go.
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It did describe that culture and I think we've all seen examples of front line staff
who seem to take the brunt of blame when things go wrong, where as perhaps
people in management positions seem to go off to other jobs with pay offs
people in management positions seem to go off to other jobs with pay offs
and that kind of thing and we've got to avoid that.
So one of the Government recommendations is that CQC take on a remit of
a fit and proper person test and I think that's going to be a huge step forward.
So to look at the leaders in health care, what are the characteristics we want to
see in good leadership, do the people that are in these positions have those characteristics?
And if we apply that test, I think that's going to be a really meaningful step towards getting that right
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Another really good question.
When looking at how well a service provides care I think it's really important
that you're not just doing that for one group of people and that actually you're looking at
everybody and that includes vulnerable groups, including people who are deaf.
So one of the things we do is with the listening events we hold, we can arrange for translators to be available.
And also in the way we inspect hospitals we've got to look at
vulnerable groups of people to see what provision is made to ensure they're getting the care that they need.
So we do specifically look at groups of people including deaf
people during our inspection process to make sure that providers are doing a good job
in ensuring that they have access to the right requirements.
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Great question and that kind of real-time feedback from people's experience
and not necessarily a complaint but actually how was the service, how was the care
and not necessarily a complaint but actually how was the service, how was the care
they were given is so valuable I think.
So there are a number of organisations that already collect that kind of feedback.
So you've got NHS Choices, Patient Opinion and what CQC is planning to do is
is to take that information from those sources and actually put it on the CQC website
so that people can look up a provider and see what the feedback has been.
Hugely valuable, tells you a lot about how a service is doing
and is something we need to do more of.
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Easy answer to the question is yes, CQC will definitely be submitting evidence
to the Health Select Committee.
It's a really important area. Just as how a trust responds to complaints from patients
about something that might have happened,
they've also got to be responsive to staff who've got concerns and I think
we've seen many examples of where staff feel unable to raise concerns and that's
really a disaster for patient safety.
You've got to have a culture in an organisation where staff feel safe and
confident in any concerns about care they may have.
So it's a really important part of the work CQC are planning to do
and we've got to get it right.
Okay, thanks very much for your questions, some really good questions.
Hope we'll get the chance to answer some more again.
In the meantime, follow CQC on Twitter (@carequalitycomm), follow me on Twitter (@jamestitcombe) and
and find out more about CQC by looking at the website (www.cqc.org.uk).