The health secretary has said that the CQC is ‘unfit for purpose’ and requires ‘increased oversight’, after the damning findings of an independent review.
North West London ICS chair Dr. Penny Dash’s interim report on the watchdog’s operational effectiveness identified low levels of inspections, a ‘lack of clinical expertise’, and a ‘lack of consistency’ in assessments. Wes Streeting claimed that he was ‘stunned by the extent of the failings’ highlighted in the report and has taken ‘immediate steps’ to address them.
Dr. Dash equally discovered that of the providers the CQC has the power to inspect, around one in five ‘have never received a rating’, and that some providers have gone years with no reinspection. The report highlighted a ‘lack of experience’ among inspectors, with reports of some visiting hospitals without ever having visited a hospital before.
Mr. Streeting has requested ‘increased government oversight’ of the watchdog, with regular updates on progress to address these issues ahead of the report’s full publication in the autumn, and the CQC was informed to ‘take immediate steps to restore the confidence of health and care providers and the public’. A former CQC chief inspector and oncologist, Professor Sir Mike Richards, has been appointed to review the organization’s assessment frameworks.
Another ‘immediate step’ announced ‘improved transparency in terms of how the CQC determines its ratings’. Dr. Dash also urged the regulator to take quick measures, such as ‘fixing faltering IT systems’. As part of her review, which started in May, Dr. Dash interviewed around 200 senior managers and doctors working across health and care.
The health secretary informed me that when he took charge of his position, it was clear the NHS ‘was broken and the social care system was in crisis’. ‘But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me the CQC is not fit for purpose,’ he said.
Mr. Streeting continued: ‘We cannot wait to act on these discoveries so far, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.’ Dr. Dash said her first report highlights ‘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,’ she added.
The CQC confirmed that it accepts the findings and recommendations ‘in full. In response to the report, many of the areas of improvement ‘align’ with its own priorities. Interim chief executive Kate Terroni said: ‘We are working at pace and in consultation with our stakeholders 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.’
She said the organization is ‘committed’ to increasing the number of inspections and to increasing the number of staff working in registration to ‘improve waiting times’. ‘We’re working to fix and improve our provider portal, and this time we’ll be listening to providers and to our colleagues about the improvements that are needed and how we can design solutions together,’ Ms. Terroni added.
The CQC admitted that it ‘got things wrong’ in the implementation of a new regulatory approach earlier this month. The regulator has also agreed to be flexible and take into account the CrowdStrike IT outage when assessing GP services. Londonwide LMCs wrote to the CQC expressing concern about the ‘impact any routine inspection activity’ might have on practices that are catching up after the’major IT disruption’. Dr. Michelle Drage, the LMCs chief executive, said: ‘I am encouraged to be advised that assessments of services will take the IT outage into account and that CQC will be flexible in their activity.’