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Some work carried out by the Care Quality Commission (CQC) will remain paused after a review highlighted significant internal failings at the health regulator
“The government may found the initial revelations in July surprising, and the CQC may act as though these issues are only just emerging; but the adult social care sector has been raising the alarm for years, calling for urgent intervention from both parties. The time for action is now. The sector can no longer afford systematic delay from those accountable for the CQC’s failures.” Professor Martin Green OBE, Chief Executive Officer of Care England
“Given the stark findings, we believe the decision to pause ICS inspections is the right one and we will continue to work with CQC colleagues to ensure the approach adds value for systems and the public.” Matthew Taylor, chief executive of the NHS Confederation
Some work carried out by the Care Quality Commission (CQC) will remain paused after a review highlighted significant internal failings at the health regulator. It comes as Health Secretary Wes Streeting suggested the public has lost confidence in the CQC’s ratings system. A final report from the CQC review – led by Dr Penny Dash, chair of the North West London Integrated Care Board – was published today.
The independent review into the Care Quality Commission (CQC) highlighted ‘significant failings in the internal workings of the CQC’ and separates these failures and potential improvements into the following areas: poor operational performance; challenges with the provider portal and regulatory platform; delays in producing reports and poor-quality reports; loss of credibility due to the loss of sector expertise and wider restructuring; concerns around the single assessment framework; lack of clarity on the calculation of ratings and the use of the outcome of previous inspections; opportunities to improve CQC’s assessment of local authority Care Act duties; concerns around ICS assessments; opportunity for CQC to improve quality across the sector; and opportunities to improve the relationship between CQC and DHSC.
Seven key recommendations have been set out by the review on how to ‘restore confidence and credibility and support improvements in health and social care’:
Dr Dash said the final report reiterates her interim findings “while providing further detail and analysis of the CQC’s performance”. The interim report. published earlier in the year, found some organisations had not been reinspected for several years, with the oldest rating for an NHS hospital dating from more than a decade ago, while the oldest for a social care provider was from 2015. It also estimated about one in five locations the CQC has the power to inspect had never received a rating, while highlight a lack of experience among some staff, including examples of inspectors visiting hospitals and saying they had never been in a hospital before.
In July of this year, Wes Streeting MP, the Secretary of State for Health and Social Care, labelled the CQC as “not fit for purpose”, failing those the organisation is meant regulate, and the individuals who rely on these regulations to guarantee them safe, high-quality care. Following publication of the full report, Mr. Streeting has now asked Dr. Dash to conduct two further reviews moving her focus from operational effectiveness to patient safety and quality of the CQC, and five other organisations. The first will explore the remits of six organisations and examine if patient safety can be bolstered through a different approach. The organisations include the CQC and the maternity programme, Healthwatch England, the Local Healthwatch network, the National Guardian’s Office, the Health Services Safety Investigation Body, the Patient Safety Commissioner and NHS Resolution. The second review will look at quality and governance, with the findings shaping the Government’s 10-year plan to transform the health service.
“Patient safety is the bedrock of a healthy NHS and social care system. That’s why we are taking steps to reform the CQC, to root out poor performance and ensure patients can have confidence in its ratings once again. This Government will never turn a blind eye to failure. An overly complex system of healthcare regulation and oversight is no good for patients or providers. We will overhaul the system to make it effective and efficient, to protect patient safety.” Wes Streeting MP, the Secretary of State for Health and Social Care
FCC Insight
We welcome Dr. Dash’s candid insights presented in the review into the CQC.
The report delivers a stark and unequivocal verdict that the CQC has failed in its core mission to uphold the quality and safety of care. The CQC’s inability to uphold the standards it was created to enforce has fundamentally undermined its credibility and eroded the trust placed in it by both the sector and the public.
The sector demands immediate action to restore confidence, and decisive leadership is essential to rectify the situation and secure a better future for service users, staff, care providers and all stakeholders alike. The system must be rebuilt and genuinely prioritise quality, safety and trust, addressing internal shortcomings and meaningful engagement with stakeholders. Establishing a regulatory environment that is transparent, supportive, and truly effective is key to restoring faith in the system and upholding the high standards of care that everyone deserves.
While it’s encouraging to see further reviews focusing on patient safety and quality, these must not become a reason to delay taking immediate action. The critical issues identified in this review are clear, and the CQC cannot afford to wait any longer to implement meaningful reforms.
Complementing the Dash Review, today has also seen the publication of Professor Sir Mike Richards’ review of the CQC’s single assessment framework (SAF) and its implementation, which has been described by Professor Richards as having “failed to deliver the benefits that were intended” following the CQC’s 2021 strategy. The review further deems the 2021 strategy’s attempts to reorganise the CQC’s structure and develop a new IT system to have also failed to deliver.