Fourteen hospital trusts have been investigated in light of their high mortality rates
The way hospital inspections in England have been carried out was flawed and they are to become broader and more robust, the new chief inspector says.
Prof Sir Mike Richards said the system used by the Care Quality Commission (CQC) had been too narrow in focus.
He wants to recruit a “small army” of doctors, nurses, patients and carers to carry out inspections and ratings.
It comes as 11 trusts have been put into special measures after previously unidentified failings were uncovered.
The move was announced on Tuesday after the publication of an independent review led by NHS medical director Sir Bruce Keogh.
An investigation into 14 hospital trusts was launched earlier this year following the public inquiry into the Stafford Hospital scandal, which said the public had been betrayed by a system which put “corporate self-interest” ahead of patients.
The trusts were identified as they had the highest death rates in 2010-11 and 2011-12.
The probe focused on whether the figures indicated sustained failings in the quality of care and treatment at the trusts.
Only two of the 11 trusts that ended up in special measures had been facing sanctions from the CQC.
‘Fair and transparent’
Setting out his plans to reform the way hospitals are inspected, Sir Mike, who formally took up his post this week, said: “We are changing it because we recognise it was flawed.”
He added the previous system, which involved carrying out themed inspections on issues such as nutrition and infection control, would be replaced by one that looked at the hospital in its entirety.
He said the changes were based on the methods adopted by the Keogh review, which he was invited to take part in.
Sir Mike said the size of the CQC inspection teams would be increased to more than 20 – they have traditionally involved about five people – to reflect the greater scope of the reviews.
They will be made up of patients, doctors, nurses and other professionals to ensure they had greater breadth of knowledge.
“I want to start building a small army of inspectors,” Sir Mike said.
“These inspectors need to come from different walks of life, some of them will be practising clinicians who will come and do two or three inspections a year, some others will be retired clinicians, but importantly we are also seeking patients and carers and we will provide training.”
Under the new regime, hospitals will also get school-style ratings of “outstanding”, “good”, “requires improvement” or “inadequate” – something that has already been announced by ministers.
Sir Mike said those deemed inadequate could also face being put into special measures, which involves teams of external experts being brought in to ensure changes take place.
And he said the CQC would be paying close attention to death rates, as well as other triggers such as patient surveys, mistakes and infection rates to see which trusts should be prioritised for inspection.
The new process would be “robust, fair and transparent”, he added.
The first wave of 18 inspections is due to start in the next month, with the aim of inspecting all 161 trusts by December 2015.
Funding of £25m for the new initiative will come from extra money announced for the CQC by Health Secretary Jeremy Hunt in April.