Regulator warns privately run NHS hospital over standards of care

BMJ 2014; 349 doi: (Published 29 September 2014) Cite this as: BMJ 2014;349:g5926
  1. Gareth Iacobucci
  1. 1The BMJ

The United Kingdom’s only privately run NHS hospital has been warned over poor standards of care by the healthcare regulator the Care Quality Commission (CQC).

Managers at Hinchingbrooke Health Care NHS Trust in Cambridgeshire, which is run by Circle Health, have been urged to tackle “poor care provided to patients” ahead of the publication of a full report of a recent CQC inspection of the trust. Hinchingbrooke became the first UK hospital to be taken over by a private company when Circle was awarded a 10 year franchise to run the trust in 2012.1

After the inspection a letter from the regulator to the trust’s chief executive, Hisham Abdel-Rahman, obtained through a leak to the Health Service Journal,2 raised several concerns about care at the trust, including instances of staff treating patients in an “undignified and emotionally abusive manner.” The letter, sent on 23 September ahead of the full report of the inspection, said that inspectors had noted cases of sedation of patients who “lacked the capacity to consent.”

The CQC said that its inspection team was concerned at an apparent “lack of recognition of the level of concerns” by the chief executive and at “the length of time it took to grasp the seriousness to patients.” It also expressed concern at the trust’s governance and monitoring of care quality, adding that its inspection team had reported “little internal or clear external oversight of how the trust managed risks to the quality of care.”

Instances of poor hygiene were also apparent, said the regulator.

The concerns have been raised just months after the trust was praised and awarded for the quality of its care by the healthcare consultancy firm CHKS.3

In a statement Mike Richards, the CQC’s chief inspector of hospitals, said that the letter was sent ahead of the publication of the full report of the inspection to enable improvements to be made swiftly. Richards said, “Following our recent inspection of Hinchingbrooke, we wrote to the hospital to expand on matters raised in verbal feedback given at the conclusion of the announced part of the inspection. This is to enable the hospital to take improvement actions without delay and is not a judgment on the trust. It is important to note that the inspection process has not yet concluded. Our inspection report and rating will be published in due course.”

NHS trusts are permitted to contest the contents of CQC reports before they are published.

Abdel-Rahman, who is also a consultant gynaecologist, said, “It’s normal for the CQC to raise queries and challenges during an inspection. We are responding, and it would be completely inappropriate to comment on that, other than to say we are working closely with the CQC and are confident our plans will meet their approval.

“Quality and safety at Hinchingbrooke has come a long way in two years. As [we are] a clinician led partnership, patients are our priority, and we are constantly looking for ways to improve our care.”

Circle’s latest half year report showed that it had made cumulative support payments to the trust of £4.85m (€6.2m; $8m), close to the £5m limit that could trigger a termination of its contract.4 The company pledged to make £311m of savings in 10 years when it took over the contract, but its forecast was questioned by the National Audit Office after it struggled to turn around the trust’s financial problems.5


Cite this as: BMJ 2014;349:g5926


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