Hancock urged to cut oversight bureaucracy

by Seamus Ward

26 August 2020


Regular inspections of providers should be paused until after the winter and steps should be taken to reduce NHS bureaucracy, including providing more funding to increase the use of digital inspections, the NHS Confederation has said.

A confederation letter urged health and social care secretary Matt Hancock to postpone regular inspections. This would give providers time to clear the backlog of care that has built up over the Covid-19 pandemic. It would also address issues such as staff exhaustion and the management of the ongoing threat from the coronavirus, it said.Danny Mortimer

During the pandemic, governance and regulation has been light touch, and the confederation said this should continue. There had been less interference from national bodies and ‘reduced requirements for meetings and paperwork that add little to patient care’, it said. The confederation’s NHS Reset campaign said the time saved has allowed NHS leaders to focus on patient care and efficiency. It added that the NHS should not return to the pre-Covid approach to governance and regulation.

The confederation acknowledged that oversight is vital to ensure patient safety. But Mr Hancock has vowed to reduce bureaucracy and it welcomed recent comments reportedly made by Care Quality Commission (CQC) chief executive Ian Trenholm, outlining his desire to reduce the regulatory burden on providers.

However, Danny Mortimer (pictured), confederation deputy chief executive, insisted bureaucracy busting must include requirements placed on the health service by NHS England, NHS Improvement and other regulators, as well as the CQC.

‘Healthcare needs regulation and oversight, but NHS leaders want to see a radical shift away from the excessive paperwork and other reporting requirements that have become an industry in recent years,’ he said.

‘All too often, these only serve to provide false reassurance, rather than enhancing patient safety. The experience of Covid-19 has shown what can be achieved when we have a lighter touch approach in place.’

He added: ‘Ultimately, we need a more risk-based, proportionate and intelligence-driven approach to regulation that fosters innovation and does not weigh providers down with reporting requirements that take them away from delivering high quality care to patients.’

The confederation made a number of other recommendations for reducing bureaucracy. These included more funding to maximise the integration of digital technology. Upgraded technology could be used to enhance the use of digital inspection and reporting. But NHS organisations needed funding to put an effective digital infrastructure in place, it said. The current £4bn Digital Transformation Portfolio, which is due to end next year, is insufficient to simplify governance and regulatory work.

It added:

  • Regulation should be proportionate and risk based
  • Regulation should be aligned with performance management to reduce duplication and streamline reporting
  • The CQC inspection regime should be revised to work at system level.