The government is to investigate the merits of a chief inspector of primary care that could produce an 'aggregated rating' on the performance of community health services.
In Putting Patients First, the government's initial response to the Francis report into care failings in Mid Staffordshire, health secretary Jeremy Hunt outlined plans to introduce a regulatory model under an independent chief inspector of hospitals, working for the CQC, plus a statutory duty of candour for healthcare providers.
He added: 'We will also introduce a chief inspector of social care and look into the merits of a chief inspector of primary care.'
But Crystal Oldman, chief executive of the Queen's Nursing Institute, said: 'It would be a challenge to have a 'chief inspector of community healthcare', as most patients are cared for in their own homes - a working environment for which we are unable to set a standard.
But we would support the idea of a chief inspector of care homes and nursing homes. So much care is delivered to frail elderly with long-term conditions in these settings and levels of care can be variable. There are three times as many beds in these homes as in hospitals.'
The CQC will be asked to draw up a ratings system for hospitals, this year, with care homes to follow. Whether GP practices are rated is still 'under consideration', and the DH has not suggested a timescale for a decision. The CQC will not be responsible for putting problems right, as its enforcement powers will be delegated to Monitor.
Howard Catton, director of policy at the RCN, said: 'The message from nurses is that there cannot be a single measure of how they perform, there has to be a system of dials and this would drive learning and improvement.'
Mr Hunt also announced controversial plans for NHS-funded student nurses to spend a year working as healthcare assistants.
Ms Oldman said: 'We welcome the renewed emphasis on practical, hands-on education for student nurses. However, many nurses already undertake caring roles as part of their preparation when considering a nursing career and many universities already have this as a prerequisite to applying for a nursing programme.'