The National Health Service regulator has called for an end to the country’s “unacceptable lottery” of hospital safety after finding that standards in four out of five NHS hospitals inspected were either inadequate or required improvement.

The Care Quality Commission said in a hard-hitting report on the state of healthcare and adult social care that “the variation in the quality and safety of care in England is too wide and unacceptable”.

“The public is being failed by the numerous hospitals, care homes and GP practices that are unable to meet the standards that peers achieve and exceed,” it added.

Of the first 82 NHS acute hospitals to be inspected, eight were rated inadequate for safety, 57 were deemed to require improvement. It defined these two categories as “care that no one would want themself of someone close to them to experience”.

However, the report stresses that these figures are not representative of the situation across England because the early inspections “focused on those that were deemed higher risk”.

The commission acknowledges that there is a “ mounting financial challenge in health and adult social care” but said “this should not excuse inadequate care”. “Providers must learn from the outstanding examples of others who have the same resources,” it said.

“There needs to be innovation to meet increasing demand, but don’t wait to innovate.”

With regard to basic safety, the commission said the two key aspects were effective safety processes and the lack of a culture that truly learns from mistakes and near misses. It also found that strong, effective leadership was “vital” – with 49 of the 82 hospitals either inadequate or requiring improvement in terms of being well led.

The commission also invited the public “to become empowered consumers” by using “CQC’s inspection reports and ratings to make decisions about your care and the care of those close to you”.

Accident and Emergency departments had the highest number of inadequate ratings, with the most common problems being overcrowding, long waiting times and inadequate staffing levels.

Medical care services had the fewest ratings of “good” while critical care had the most.

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