Closed petition Independent inspection of all health facilities, including community care

The Minister for Health and Social Services supports regulation and independent inspection of hospital services and work is being brought forward to bring the full inspection of hospital and associated services within the remit of the independent Jersey Care Commission.

Independent inspection of services is vital to providing assurance about the quality, safety and effectiveness of health and social care. The Minister and the Health and Community Services Department (HCS) welcome such scrutiny. They recognise the role that inspection plays in helping ensure that Islanders receive the best quality care and are protected from potential harm.
Furthermore, they recognise that inspection by an independent body is central to maintaining public confidence in services.
The Regulation of Care (Jersey) Law 2014 (“the 2014 Law”), which established the Jersey Care Commission (“Care Commission”) as Jersey’s own independent care regulator, came into force in 2019. From the outset, the States Assembly agreed that hospital services would fall under the remit of the Care Commission but that a phased approach would be taken with hospital services regulation being provided for at a later date. As set out at the time, it was provisionally intended that hospital services would be regulated after care homes, home care services and adult day care services – which have been regulated since late 2019 – plus children and adult social work services.
The Minister for Health and Social Services recognises, however, that there are legitimate calls for an earlier inspection of hospital services as demonstrated by the level of public support for this petition. The Minister supports regulation and independent inspection and since the launch of the petition he has consulted both the Council of Ministers and the Care Commission and agreed with them that work should commence in the coming weeks on extending the provisions of the 2014 Law to hospital and associated services.
This will place providers of those services under a legal requirement to register with the Care Commission in order that the Care Commission may undertake independent inspections.
If the proposal to extend the provisions of the 2014 Law is adopted by the States Assembly, it will be the responsibility of the Care Commission to determine how hospital inspections are delivered. This may include contracting with UK-based inspectors, such as the Care Quality Commission, to undertake the work. Contracting with UK inspectors is an established model of working; the Care Commission has previously contracted Ofsted – the UK’s independent inspector of schools and children’s services – to undertake inspections on its behalf.
Providing for inspections that are planned, managed and overseen by the Care Commission under a legal framework has distinct advantages over the Government of Jersey directly contracting with a UK inspector such as the Care Quality Commission as proposed in the petition. These advantages include:
• assurance of independence: the Care Commission, and not the Government of Jersey, will control the inspection process, will set the inspection brief and will determine which services should be inspected in what order. Islanders will know that their services are independently inspected against standards established in law, as opposed to inspected by external inspectors who would not have statutory powers, such as rights of entry onto premises and to require disclosure of information;
• powers to direct improvements required: as inspections will happen under a legislative framework, the Care Commission will be able to issue improvement notices thereby setting out what must be done within a given timeframe. Failure to comply with improvement notices will be an offence. In the event that the Government of Jersey was to directly commission UK inspectors, those inspectors could do no more than make recommendations;
• remit to inspect and impose requirements on services beyond those directly provided by Government: the Care Commission will have the remit to register and inspect services other than just government-provided services. This will provide greater assurance and protection for Islanders.

The Jersey Care Commission is independent of Government. This independence is enshrined in Article 36 of the 2014 Law which prohibits Ministers or, by extension, Government officers from directing the activities of the Commission or interfering in any inspection process.
It is anticipated that the necessary legislative provisions will be lodged for debate by the States Assembly in 2023 allowing for the Care Commission to independently register and inspect hospital and associated services from 2024.
There will be opportunities for full public consultation as the legislative provisions are developed.
In the intervening period, the Care Commission will be preparing to undertake an independent survey to better understand patients’ experience of HCS’s services. The information and learning that arises from that survey will help inform future inspections.
HCS is committed to openness and transparency and, whilst work is underway to bring forward a regime of statutory inspection, the Department will continue to publish its quarterly Quality and Performance Report setting out how its services are meeting quality and performance standards; will remain subject to specific service inspections, such as those related to pathology and radiology services; and will continue to engage in assurance processes such as the Jersey Nursing Assessment and Accreditation System.
https://www.gov.je/government/pages/statesreports.aspx?reportid=5475
Furthermore, the Care Commission will continue to inspect the HCS services that are currently regulated under the 2014 Law such as its care homes and day care centres https://carecommission.je/inspection-reports/