Final Report > Chapter 27: Care of an Appropriate Standard > Generic standards for healthcare organisations > Rationalising the `inspection industry': a single body to validate healthcare organisations

Rationalising the `inspection industry': a single body to validate healthcare organisations

39 Currently there is no effective co-ordination of the various external inspections and assessments that trusts are required undergo, or of the generic standards they are required to follow. Apart from putting an unnecessary administrative burden on trusts in dealing with these activities, there is inconsistency and an inevitable fragmentation of the process, with the consequent danger that matters are overlooked. Thus instead of the National Health Service Litigation Authority (NHSLA), the Royal Colleges, the Health and Safety Executive, the Audit Commission and numerous other bodies issuing standards independently and considering separate aspects of the trust's management, in the future these various standards and forms of external inspection must be integrated into a single validation process. There must be a single, coherent, co-ordinated set of standards with which NHS organisations have to comply, overseen by a single validation process and a single validating body. By a single validating body, we do not mean that one body should itself set all the standards and or undertake all aspects of the process. [21] What we mean is that one body should be in overall charge, ensuring that the generic standards exist, that they are consistent and coherent, and capable of implementation within an organisational setting. Further, that a single body should take a view as to how well the trust meets all the generic standards. CHI, suitably structured so as to give it the necessary authority and independence, is well placed to adopt this role.

40 The place and role of the Audit Commission is a specific example of the case for rationalisation. In terms of its role of ensuring the proper stewardship of public finances, which is carried out through the Commission's District Audit Service, we see no overlap with other bodies. Indeed this activity must continue. But in terms of its other role of helping those responsible for the NHS to achieve economy, efficiency and effectiveness, there is now a degree of overlap with the role and functions of CHI. We recognise that during the 1990s the Audit Commission helped to fill a vacuum in addressing issues to do with clinical effectiveness and comparative performance. Our concern, however, is that notwithstanding the high quality of their work they continue to provide reports on such matters, even though other bodies, in particular NICE and CHI, are now established. In proposing a single validating body and the rationalisation of the inspection industry, therefore, we see the need for reappraising the future of this second role of the Audit Commission.

Footnotes

[21] We see scope for collaboration between a programme of validation led by CHI and the many voluntary accreditation programmes currently available and used by many trusts