Anna Walker, the new chief executive of the Healthcare Commission (the new name for CHAI, previously CHI—Commission for Health Improvement) spoke for the first time at a BAMM conference. She is new to healthcare, having previously been a Director General at DEFRA and before that at the DTI), but already shows an impressive grasp of the major political, strategic and practical issues facing the Commission.
The Healthcare Commission has regulator responsibility for the whole healthcare spectrum: NHS, private healthcare and voluntary organizations, working within a framework of government standards. Like CHI, it will undertake annual provider reviews, themed reviews, and investigate problem or failing organizations. In addition, it will likely take on the second stage of the NHS complaints process. It aims to do this with substantially fewer people and resources than sister organizations such as OFSTED. It will therefore not be relying on armies of paid inspectors (though may continue to second people from within the NHS, as did CHI) and will rely on organizations submitting a detailed self-assessment which will be rigorously analyzed and screened for deviations. Detailed inspection visits will probably be confined to poor performers, and high flyers. Cross-boundary issues are likely to be an early priority.
Asked if the Commission would tackle the government if its surveys or inspections found problems arising from central policy, Anna Walker made it clear that the Commission will be feeding back regularly to the Department of Health and would be prepared to ‘say the unsayable’ if it came across such problems. The Commission will also take into account improvement (relative performance) as well as absolute performance in its assessments, and recognizes that locality commissioning poses particular problems for hospital Trusts that have to work with multiple Primary Care Trusts.
