This week has been dominated by the topic of hospital inspection


On Monday the Keogh report was announced. Behind the distracting political noise the NHS crossed a really important threshold. For the first time, we saw hospital assessment as it should be – credible, meaningful, open, involving, comprehensive, constructive and helpful. As a consequence, the findings will surely be accepted by hospital boards, staff, and the public alike


Today, the Chief Inspector of Hospitals commenced work by announcing details of his routine hospital inspection process which, while not triggered by high mortality rates, seems to build on the approach used in the Keogh reviews


A large inspection team, with a varied membership including members of the public, expert clinicians, junior doctors, and student nurses will spend sufficient time to really understand the organisational culture. They will meet staff and patients and they will visit in and out of normal working hours


We are pleased to be one of the first 18 Trusts to be visited, potentially very soon. Some time ago we volunteered to help trial the new ‘Ofsted style’ rating system, so we are equally pleased to be one of 3 Trusts (as I understand it) to be rated in this way after our inspection


How to prepare? Indeed, should we prepare? Certainly we should inform staff about it, as we do whenever we are mentioned in national media. I have done that today – you can read my message here


I think it is difficult if not impossible to prepare – why would we, and what would we do differently? The teams, experienced as they are, will form an accurate impression of our organisation whatever we do between now and the big day. It seems to me that this is a key strength of this new system of inspection?


Professor Richards was instrumental in implementing cancer peer review inspections just over a decade ago. I was involved as a clinician, and I recall the early angst. But quickly the power of peer review became apparent, and now the validity of the visiting team’s findings is rarely questioned, and the improvements that have resulted are many and varied. I can see strong parallels with the new inspection process


Am I worried? Of course – however hard one works, and however committed one is to doing the right things, it is always anxiety-provoking to be scrutinised by others. We are on a journey in our Trust. Currently we are a middling performer overall, but with aspirations to keep improving. We think we are doing the right things, choosing the right priorities, and operating in the right way, but we are open to learning how to be better


Managed correctly, the findings of the visit will help us support our Trust to become even better. The importance of the five domains (well led / responsive / caring / effective / safe) is unarguable, and a balanced assessment of our performance against these will be difficult for even the most hardened opponent of change to resist


In this baking hot week, we have moved into a new era of hospital performance assessment. I believe it will be balanced, and rooted in the views of clinicians and public, and thereby credible and powerful. Most important of all, we will have an approach to performance measurement that our staff will recognise as valid, and will support. That can only strengthen the alignment between front line staff and their managers, and that in itself will be a huge step forward