Launching a report following the Health Committee’s annual accountability hearing with the CQC, Committee Chair Stephen Dorrell MP said:
“The CQC has been a case study in how not to run a regulator, but essential reforms implemented by the new management are turning the CQC around.
“The CQC has a renewed sense of purpose and now understands that it exists to ensure that care providers meet basic standards and to intervene when they do not.
“Putting in place systems to inspect hospitals and care homes proved too much for the CQC in previous years. Inspections were superficial and produced reports which bore little relation to reality, but the CQC now has a coherent plan to make sure providers are properly examined.
“Giving inspection teams the time and tools to understand what is really happening in hospitals, GP surgeries and care homes is fundamental. The CQC is now doing this by recruiting specialist inspectors who can understand and interpret what they observe during inspections.”
The Health Committee’s inquiry also examined the CQC’s decision to introduce risk based regulation alongside a rating system which will issue providers with overall ratings ranging from ‘inadequate’ to ‘outstanding’. Stephen Dorrell MP said:
“Differentiated regulation is the right approach and will allow the CQC to target providers where failures would pose the greatest threat to patient care, without placing an excessive burden on routine services.”
Mr Dorrell cautioned, however:
“There are some providers where services are inherently high risk and where regular inspection is a vital component in maintaining the highest possible standard of care.
“Achieving an ‘outstanding’ rating should never mean that high risk services are allowed to operate without oversight. Providers must not regard being awarded a positive rating from the CQC as a mechanism for escaping scrutiny.”
The CQC is also introducing an new surveillance system which includes a large range of indicators related to quality of care. The CQC refer to the indicators as ‘smoke detectors’. When they suggest a provider is outside the expected range of performance then further examination and inspection will be triggered.
Stephen Dorrell said:
“Underpinning the new inspection regime with a detailed surveillance system is a necessary way of monitoring providers. It is particularly welcome that the CQC will include data on staffing levels within the indicators and the Committee is keen that this should include key information such as the ratio of registered nurses to patients on hospital wards.”
“For the surveillance system to be successful the CQC must demonstrate that it can pick up on problems before they become known to the general public. If surveillance is perceived as slow, or reactive, it will not enjoy public confidence and credibility.”
The Committee expressed concern regarding the CQC’s new responsibility to oversee the financial performance of adult social care providers. Mr Dorrell said:
“The CQC regulates care quality and not financial performance. We recommend that the Government should reconsider the proposal that the CQC should widen its remit in this way.”
Finally Mr Dorrell added:
“The Department of Health has asked the CQC to oversee the introduction of the fit and proper persons test for the Directors of care providers, but perversely the test will not be applied to the Chairs of NHS Trusts or Foundation Trusts. We do not believe this exclusion will be understood by patients or the public.