The effect of external inspections on safety in acute hospitals in the National Health Service in England: A controlled interrupted time-series analysis (12 April 2019)

Summary

This study evaluated the effect of Care Quality Commission external inspections of acute trusts on adverse event rates in the English National Health Service using two control groups: new versus historical inspection regime and trusts not inspected.

The study found that, in one year, the Care Quality Commission inspected 66 acute trusts (42% of all English trusts) using their new regime and 46 (30%) using their previous one. Prior to inspections being announced, rates of falls with harm and pressure ulcers were improving in both intervention and control hospitals. The announcement of an inspection did not affect either indicator. After inspections, rates of falls with harm improved more slowly, and pressure ulcer rates no longer improved for trusts inspected using both regimes.

It concluded that neither form of external inspection was associated with positive, clinically significant effects on adverse event rates. Any improvement happening before the announced Care Quality Commission inspections slowed after the inspection.