Professor Sir Mike Richards, the Care Quality Commission's chief inspector, has warned that the NHS is standing on a "burning platform", and that the model of acute care that once worked well "cannot continue to meet the needs of today's population".
"The need for change is clear, but finding the resources and energy to deliver that change while simultaneously providing safe patient care can seem almost impossible," he said.
His comments come with the publication of the CQC's State of Care in NHS Hospitals review, which painted a picture of mixed quality across the country both between hospitals and between individual core services within the same hospital.
It showed that, across all acute trusts, critical care services and services for children and young people received the most ratings of good and outstanding (66 percent and 68 percent respectively). Of all the core services CQC rates, urgent and emergency services received the highest number of inadequate ratings (9 percent) followed by medical care (5 percent).
Safety remains a key concern, with 11 percent of NHS acute non-specialist hospital trusts issued an inadequate rating and 70 percent 'requires improvement' in this category, which means that more than four in five hospitals across the country needs to improve in this area, the watchdog said.
Critical issues identified included high bed occupancy rates, poor infection control, inadequate recognition of deteriorating patients and intervention with appropriate treatment before their condition worsens, and poor management of inpatients that have diabetes in addition to their main reason for admission.
"Safety remains a real concern, often due to a failure to learn when things go wrong. Strong leadership that instils a culture of learning and an environment where staff are listened to can play a vital part in bringing about improvements," Prof Richard's noted. "But compassion is alive and well…overwhelmingly, we see staff behaving in a caring way, which is supported by what we hear from patients. The unwavering dedication and commitment of staff shines out from our inspection reports".
"The scale of the challenge that hospitals are now facing is unprecedented - rising demand coupled with economic pressures are creating difficult-to-manage situations that are putting patient care at risk," he warned, but added that the CQC's report demonstrates that "transformational change is possible, even in the most challenging of circumstances," and that "moving away from an insular approach and actively sharing learning between organisations will be increasingly vital if the whole system is to move forward together".