Abstract

Aim: To compare the new and old regime of CQC inspections on adverse events when accounting for previous level of improvement. Methods: Interrupted time-series study using a mixed-effect multilevel random-coefficients model. Falls with harm and pressure ulcers from April 2012 to June 2016 were used. Date and type of inspections were retrieved from www.cqc.org.uk. One interruption was month of CQC inspection and other its announcement (4 months before). Improvers had a negative trend before inspection and no improvers a trend of zero or positive. Results: 143 (92%) acute Trust included, no improvers were 47 (33%) Trusts. Mean(SD) falls were 0.008(0.009) and pressure ulcers were 0.05(0.02) during pre-inspection period. The rate of change for no improvers before inspection was 1 fall and 6.4 pressure ulcers per 10,000 patients/month. There is an abrupt reduction on adverse events for no improvers after announcement (-29.1 falls; - 111.6 pressure ulcer per 10,000patiens/month) and a change of trend after CQC inspection (-1.2 falls; -1.9 pressure ulcer per 10,000patiens/month), which are similar for old and new regime. Improvers hospitals had no significant changes. Conclusion: Hospitals with poor safety outcomes benefit from CQC Inspections, therefore targeting inspections to poor performance hospitals is recommended.