Five challenges organisations facing inspections should address

19 September 2018


by Yvonne Mowlds Partner, Health Forensics Lead

Email +44 (0)7715 771381

The ability of an NHS board to have line of sight through what can be a complex and disparate structure is a key characteristic of any well led organisation. In a technologically enabled world, we expect to have instant access to information that is meaningful and that facilitates effective decision making and continuous improvement. The complexity of NHS bodies, combined with a slower pace of technology adoption, means that this information is currently less likely to be available.

During Care Quality Commission (CQC) inspections, inspectors consider how well led an organisation is. A key line of enquiry is whether “appropriate and accurate information” is “being effectively processed, challenged and acted on”. From our work with organisations across the NHS we have learnt that there is a correlation between those that are rated as “good” or “outstanding” and the amount of insight board members have into the risks and challenges across their organisations. What is particularly important is that the information is easily accessible and that there is evidence that this information is used to drive continuous improvement.

Within organisations that are rated as “requires improvement” or “inadequate”, there is often poor line of sight through the organisations, with the board not always being aware of the  issues which were subsequently identified during inspections. The CQC often find that information and data do not consistently facilitate effective learning or improvement.


Through our reviews of NHS providers we have identified five challenges that organisations should address:

  1. Significant clinical time is spent undertaking inspections of healthcare settings without any clear benefit - for example, nurses manually inputting inspection results into spreadsheets.
  2. Boards are not requesting the information they need to get line of sight through the organisation.
  3. Data is not presented in a way that allows for identification of themes or underlying issues.
  4. Boards are receiving data that is several months old, meaning that decisions are taken based on out of date information.
  5. The same issues occurring on numerous occasions through failure to act on or learn from information,

Doing something about it is vital. The ability to access meaningful, timely information can be a key enabler to improve the learning culture and improving overall performance.

Through our work we often make a range of recommendations to help to improve line of sight and quality of decision making in organisations. The Secretary of State for Health and Social Care, Matt Hancock, has made clear that improving the NHS’s digital infrastructure is key to future outcomes.

As part of our commitment to safe, high quality, sustainable healthcare and our passion to find digital solutions that deliver real, on the ground change, we have recently invested in the technology business that has developed the Perfect Ward app.

Perfect Ward has been developed by healthcare technology startup Bolt Partners and is a user-friendly digital inspection app for mobile phones and tablets.

Not only does the app allow for digitally enabled inspection of healthcare settings, delivering higher quality inspection and saving significant amounts of clinical time, it also provides real-time reporting. This gives clinicians, managers and board members a richer source of information that can be easily interrogated to enable decision making and continuous learning. Critically,  it has the potential to align internal data requirements with those of regulators, including the CQC and NHS Improvement, thus reducing the ‘burden of regulation’

To find out more, please go to Perfect Ward or contact Yvonne Mowlds who would be happy to provide you with further information.

by Yvonne Mowlds Partner, Health Forensics Lead

Email +44 (0)7715 771381