Serious concerns raised following publication of interim review into the effectiveness of the CQC
The Care Quality Commission (CQC) is the independent regulator of health and social care in England. Every provider of healthcare and adult social care who conducts regulated activities must be registered with the CQC.
The CQC according to its own data published in June is responsible for the regulation of over 53,000 organisations .
The CQC has been criticised in several ways in recent years. Firstly, for its failure to look after whistleblowers. The National Care Association also published an open letter about the CQC’s ‘hostile’ inspection visits. The British Medical Association has commented on the CQC’s poor inspection rate and ratings generally .
Effectiveness of CQC examined in report
Dr Penelope Dash, independent lead reviewer published an interim report on 26 July, 2024, into the operational effectiveness of the CQC.
Health Minister Wes Streeting said he was “stunned by the extent of the failings” identified in the interim report. It described how the CQC has lost credibility in the sector and that it was failing to inspect enough premises in a short enough period.
Data provided by the CQC identified that one NHS hospital had not been inspected by the CQC since 2014 and its rating dated from June 2014 (when it is known that reports are published often weeks or months after an inspection). It's estimated that one in five regulated premises has never been inspected.
Concerns over experience of staff
There was also criticism in the report that staff weren't experienced enough including some inspectors tasked with inspecting hospitals who had never visited one before. There was also a lack of consistency in assessments and disruptive IT issues identified.
The CQC gives four levels of ratings for organisations following inspection, either outstanding, good, requires improvement and inadequate.
The CQC has previously identified that more than half the hospitals in the country are rated as inadequate or requires improvement.
A report by patient safety charity Action against Medical Accidents (AvMA) in 2016 reported that a quarter of CQC inspection reports had little or no evidence that the regulator was taking steps to ensure that NHS Trusts improved .
Wes Streeting told BBC Radio 4’s Today programme on 26 July, 2024, that, “I would take those ratings today with a pinch of salt. One of the reasons why I’ve chosen to publish the interim report from Dr Penny Dash is, firstly, to be open and transparent and honest with the public urgently, but secondly, to make sure that we ask the CQC to urgently qualify those ratings by providing the background information on how the rating was determined, so that people can make more informed decisions.”
Immediate recommendations to improve the CQC
Dr Dash identified five recommendations that need to be undertaken immediately:
- Rapidly improve operational performance.
- Fix the provider portal and regulatory platform.
- Rebuild expertise within the organisation and relationships with providers to resurrect credibility.
- Review the Single Assessment Framework to make it fit for purpose.
- Clarify how ratings are calculated and make the results more transparent particularly where multi-year inspections and ratings have been used.
Medical negligence lawyer's conclusion
Whilst it's concerning that such significant problems have been identified by Dr Dash, a clear action plan has been identified.
Work is already being done to improve the CQC. It's important that ratings accurately reflect the care being provided by the organisation being inspected so that patients and service users have confidence in the care provided. The substantive report being prepared by Dr Dash is due to be published in autumn 2024.
Find out more about Irwin Mitchell's expertise in supporting people with care concerns at our dedicated medical negligence section.
