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CQC unfair to QEH

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I have waited a good while since the Care Quality Commission published its damning, but clearly flawed, criticism of the Queen Elizabeth Hospital in King's Lynn.

I speak purely in relation to the inference, following some ad-hoc inspections, that the quality of caring by staff seems to have gone down since the last checks some months earlier.

Then, in the latter part of 2018, the caring was deemed to be "good" but in the March/April inspections of this year it was said to have "required improvement".

QEH General Views of the outside of the hospital (21116505)
QEH General Views of the outside of the hospital (21116505)

I can only stand up for the staff on one ward, but no doubt others elsewhere in the hospital might feel similarly slighted.

I have been a volunteer for Macmillan Information and Support within the QEH for more than three years and for some months now have additionally felt privileged to help on the Shouldham palliative care (cancer) ward where I pop in sometimes two or three times a week to help serve breakfasts and lunches and teas and coffees.

I can see, hear and almost feel the care going on around me in a tough and sometimes traumatic environment.

The staff at all levels portray skills that I believe are not possible to learn in a classroom or from text books.

Qualities such as sympathy, empathy, consideration,understanding, tenderness, tolerance, devotion, people skills, building a genuine rapport with patients and relatives, changing soiled beds without complaint, relating to those who know they have limited life expectations, encouraging others etc, plus of course medical knowledge and experience are ones that surely can only come from the person inside.

To that end, I wonder if an inspector would want to tell someone to their face that they do not care as much as they used to.

Of course, I can only guess that people or the system, has been marked down because they did not fill in report forms or tick boxes to log they have monitored this, that or other, possibly or probably too busy doing the caring in the first place or simply sidetracked to help another patient in need.

I wonder how many patients were actually asked for their opinions on the quality of care.

I speak to patients frequently and they constantly praise the care.

And, more formally, as a volunteer I also help patients fill in the nationally-recognised Friends and Family Test forms, which gives them a confidential chance to express their views just before they leave.

I have done dozens of the forms, on which the first question asked is: How likely are you to recommend this ward to a member of your family or friend if they needed similar treatment.

Apart from one, I think, all the answers were: Extremely likely or likely.

The patients seem content.

Aren't their views important?

And what about getting the views of patient representative groups?

I attend meetings of the increasingly-active West Norfolk Cancer Services User Group, which brings patients, past and present, together with professionals and jontly look at ways to bring about improvements.

Can't remember their opinions being sought either.

Perhaps the CQC could look at ways to improve its own reports.

It needs to realise that these are are not only read by medical professionals but by the average man or woman in the street.

If they read that the care was "good" last year, but now "requires improvement" they will only assume that the staff are not caring like they used to.

That's just not true.

Of course, as a watchdog, the CGC has a vital role to play.

When there are mistakes, they need to be highlighted, acted upon and every effort made to make sure the same thing does not happen again.

That will be of no comfort of course in the rare cases when someone has lost a loved one.

And I would share their anger, hurt and disgust.

But the CQC's 80-page report tells us that in the year March 2018 to March 2019 at the QEH there were 79,685 inpatient admissions; 315,519 outpatient attendances and 66,333 seen in A&E.

Nearly half a million cases!

In comparison the nunber of complaints was miniscule, I believe.

I am sure the QEH and staff are learning all the time, adopting new and better practices, using technologies etc – but even in the best of places there will be some mistakes occasionally...

... Rolls Royce cars do break down; multi-million pound planes drop out of the sky for reasons no-one ever finds out; top restaurants serve up food poinsoning; hugely and mostly overpaid footballers miss a simple penalty... and at some stage this year a hard-pressed, overworked nurse or doctor just might forget to tick a box to say something had been monitored.

Perhaps I am wrong to wonder if in these days of inspection after inspection, if anyone actually inspects the inspectors?

Is the system checked regularly? How experienced are the inspectors? When was the last time they did an 8-10-hour night shift in a high-dependency ward?

At least the CQC does open itself to some inspection via its own website.

And I apologise if I slight any of its staff, but it appears that the inspectors who watch other people work are paid significantly more than the nursing staff doing the work.

So far as the Shouldham ward is concerned, I would say that the level of care is not just very good – it is exceptional.

I realise I have written hundreds of words, but few in comparison with the thousands presented by the CQC.

But I must just have a say regarding the CQC's comments on end-of-life care at the QEH which it judges as being inadequate, claiming people were not treated with compassion and kindness in their hours of need.

I can think of at least two families in recent months who I am sure would testify that they could not have wanted or expected more from the way they were supported during the final days and hours their loved ones were looked after by staff on Shouldham ward.

In one case exceptional arrangements were for a couple to marry on the ward in a side room, flowers provided, a member of staff loaned a wedding dress. It was a proper and emotional service.

Sadly the groom died a couple of weeks later in a hospice.

In another case special arrangements were made so that a wife and two daughters were able to remain close to a man, who finally drifted away after a long and brave fight.

A number of staff attended his funeral.

Who has the audacity to say that the family were not treated with compassion and kindness?

Yes, I can be accused of being biased.

My links with the QEH go back a good 30 years.

As a senior journalist and then editor of the Lynn News I drove fundraising campaigns which brought in around £2m of new facilites, including our readers rasing half the cost of the first Macmillan unit; the first CAT scanner; first mobile mamogaphy unit; the Helipad; maternity ward revamp etc.

And on a more personal level, all three of my daughters were safely born there; my mother died there (age related) and early diagnosis by the QEH resulted in me receiving a lifesaving transplant the day before Addenbrooke's consultants thought I would die.

The QEH's watch words are: Act Well; Listen Well; Care Well.

Its staff do their best to achieve the goals contantly.

(Since I first wrote this letter, I have been delighted to read that a national survey of cancer patients' experiences has placed the Queen Elizabeth Hospital among the top performers in the country.)

Malcolm Powell,

Volunteer, Queen Elizabeth Hospital; former editor, Lynn News; former President, West Norfolk Chamber of Commerce and former chairman King's Lynn Town Centre Partnership.

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