Care Quality Commission (CQC) 'not fit for purpose', says Wes Streeting

An independent review finds significant failings in the effectiveness of Care Quality Commission. Wes Streeting orders the publication of the interim report to initiate immediate actions

Health Secretary Wes Streeting has announced four immediate steps the government will take to restore public confidence in the effectiveness of health and social care regulation, including increased oversight of the Care Quality Commission (CQC).

This announcement follows an independent review of the CQC, which revealed significant internal failings that hinder the regulator’s ability to identify poor performance in hospitals, care homes, and GP practices.

The interim report, led by Dr. Penny Dash, Chair of the North West London Integrated Care Board, found that inspection levels were well below pre-COVID standards. It also identified a lack of clinical expertise among inspectors, inconsistencies in assessments, and problems with CQC’s IT system.

These failings hinder the regulator's ability to consistently and effectively evaluate the quality of health and care services, including those requiring urgent improvement.

Additionally, the report noted that social care providers face prolonged waits for their registration and rating updates, affecting local capacity.

Streeting said: “When I joined the department, it was already clear that the NHS was broken and the social care system 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 CQC is not fit for purpose.”

In response to these findings, the Health and Social Care Secretary has ordered the publication of this interim report to initiate immediate actions for improving regulation and ensuring transparency for patients.

A full report on the independent review is expected to be published in the autumn.

“I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care,” Streeting said, reassuring his commitment 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,” he added.

Meanwhile, the CQC has been asked to take some immediate steps to restore the confidence of health and care providers and the public.

These include the appointment of Professor Sir Mike Richards, a senior cancer doctor, to review CQC assessment frameworks.  Sir Mike was a hospital physician for more than 20 years and became CQC’s first Chief Inspector of Hospitals in 2013, retiring from this role in 2017.

Other urgent actions include:

• Enhancing transparency in how the CQC determines its ratings for health and social care providers
• Increasing government oversight of the CQC with regular progress updates to the department, ensuring the implementation of Dr. Dash’s final review recommendations
• Requesting Dr. Dash to evaluate the effectiveness of all patient safety organisations

Dr. Dash was commissioned to review the CQC in May 2024. Over the past two months, she has consulted with approximately 200 senior managers, caregivers, and clinicians from the health and care sector, as well as over 50 senior managers and national professional advisors at the CQC.

Commenting on her findings so far, Dr Dash said: “The contents of my interim report underscore the urgent need for comprehensive reform within 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 that the 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.”

To begin restoring its credibility, Dr. Dash has emphasized urgent actions for the CQC, including overhauling the inspection and assessment system, rapidly improving operational performance and fixing faltering IT systems.

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