CQC “Not Fit For Purpose” Says Health Secretary
The Care Quality Commission (CQC) is “not fit for purpose”, health and social care secretary Wes Streeting has stated, after a critical report revealed significant failings within the regulator.
An interim report from Dr Penny Dash found the CQC’s ability to identify poor performance at hospitals, care homes and GP practices and domiciliary care had been hampered by its own issues, including low levels of inspections, a lack of clinical expertise amongst those carrying them out, a lack of consistency in assessments and IT issues.
The report found the CQC was unable to effectively assess the quality of health and care services, including those in need of urgent improvement.
It also said social care providers were left waiting too long for registration and ratings to be updated, leading to an impact on local capacity.
Health Secretary Wes Streeting, who ordered the report to be published ahead of a full assessment due in the autumn, said he was “stunned” by the findings, which demonstrated the organisation was “not fit for purpose”.
He added: “I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care.
“I want to reassure them that I am determined to grip this crisis and give people the confidence that the care they’re receiving has been assessed. This government will never turn a blind eye to failure.”
Dr Dash, chairwoman of the North West London Integrated Care Board, found some organisations had not been reinspected for several years, with the oldest rating for an NHS hospital dating back over 10 years ago while the oldest for a social care provider was from 2015.
Of the locations the CQC has the power to inspect, it is projected about one in five have never received a rating, the interim report found.
It also revealed a lack of experience among some staff including examples of inspectors visiting hospitals and saying they had never been in a hospital before as well as an inspector of a care home who had never met a person with dementia.
The CQC said it accepted the full findings and was “working at pace” to “rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve”.
Mr Streeting promised urgent action and enhanced oversight of the CQC, announcing the appointment of former chief inspector of hospitals Professor Sir Mike Richards to review its assessment frameworks.
The government also promised to improve transparency over the watchdog’s ratings for health and social care providers and ensure the CQC regularly updates the Department of Health on its progress.
Dr Dash has been asked to review all patient safety organisations for any of their own issues.
She said: “The contents of my interim report underscore the urgent need for comprehensive reform within the CQC.
“By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England.
“Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.”
Dr Dash has called for urgent action from the CQC to overhaul its inspection and assessment system, as well as fixing its IT issues.
Commenting on the findings Professor Martin Green OBE, Chief Executive of Care England said:
“It is clear that Dr Dash has listened to the voices of care providers, resulting in a clear set of recommendations. This report acknowledges the severe and systemic problems that sit at the very heart of the CQC, and gives a specific set of steps that the regulator must take to improve performance and re-establish the sector’s long-eroded trust.
“This is going to be a long and difficult journey for the CQC, but one that is entirely necessary. Care England stands ready to work with the regulator to help them deliver an effective and supportive regulatory system that will be the cornerstone of public protection and delivers fair judgements across health and social care.
“The CQC must embark on a radical improvement program that should not only include some tangible improvements in their performance, but also needs to move away from a culture of blame. We all want proportionate and effective regulation, and the challenge now is for CQC to take action and work with organisations across the sector to deliver it.”
Matthew Taylor, chief executive of the NHS Confederation, said:
“Health leaders recognise that there have been a number of failings, already acknowledged by interim Care Quality Commission chief executive, in rolling out the new regulatory assessment regime and they and the teams they manage often report feeling overloaded and dissatisfied with the state of the present model of regulation.
“NHS leaders frequently say they feel the current system is out of step with the parameters in which they are operating and doesn’t recognise the full extent of the pressures they are working under.
“So our members will be pleased to see the government is taking swift action on the failings identified as set out in the interim report of the regulator by Dr Penny Dash, chair of the North West London Integrated Care Board, with whom the NHS Confederation and its members have engaged in this ongoing review.
“Identifying these failings is the first of many steps it will need to take towards improvement, and we look forward to working with the CQC to develop solutions to restore the confidence of our members and the public in the future regulation of the NHS and adult social care.”
