Care Quality Commission deemed not fit for purpose
Wes Streeting has claimed the healthcare regulator is so poorly managed that hospitals, care homes and GP practices shouldn’t trust it’s reviews.
Public care doctor Penny Dash previously launched a review into the Care Quality Commission (CQC) – the public body responsible for inspecting health institutions in the UK. The findings are far from satisfactory. The report discovered that the CQC is plagued by low levels of physical inspections, a lack of consistency in assessments and problems with IT systems.
Following this, health secretary Wes Streeting has claimed that the CQC isn’t fit for purpose in its current state.
Talking to the BBC Radio 4 programme this morning, Streeting said: ‘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.’
Looking at the report’s findings in greater detail, some of the CQCs failings include:
- Inspectors lacking the necessary experience – one example is someone being asked to review a hospital even though they’ve never visited one previously
- Care home inspectors were hired despite having never met with a person with dementia
- One NHS hospital having gone more than 10 years since it’s last inspection
Streeting has assured people in this country that he plans to prioritise getting a grip on the CQC crisis as soon as possible. To do this, he has announced four immediate steps which include recruiting a senior cancer doctor to review the body’s assessments.
In addition, the regulator has been asked to regularly report to the Department of Health and Social Care when it takes steps to reform its practice.
Dr Dash currently chairs the board overseeing North West London’s health and care system. To conduct the report she has interviewed more than 200 senior NHS staff and carers along with more than 50 people who work for the CQC to draw up her interim findings.
Her final report is set to be published in full this autumn.
The complaints raised today aren’t the first. This month the CQC have already had to apologise this month after care organisations complained of a ‘hostile’ inspection regime. The body’s former chief executive, Ian Trenholm, quit at the end of last month midway through the implementation of changes that were supposed to improve assessments. As a result of this, one of Streeting’s first tasks will be finding a replacement.
Commenting on the news, Suhail Mirza, non-executive director at Newcross Healthcare, said: ‘Any meaningful reform and flourishing of the social care sector is predicated on a regulator that not only assures compliance but fosters the space for creativity of operators. It’s a theme we have seen as a current across many of our Voices of Care episodes with leading lights across the sector.
‘The review of Penny Dash it is hoped will act as a catalyst for a mindset from the regulator that empowers providers. One hopes the regulatory rubicon has been crossed.’
Echoing a similar tone, leading social care consultants from Fulcrum Care have also responded to the CQC report.
‘Fulcrum Care welcomes the recent report highlighting significant internal failings within the Care Quality Commission (CQC),’ they said. ‘As an independent national consultancy, Fulcrum Care has been at the forefront of supporting health and social care services, having worked closely with hundreds of care providers over the years. For context, Fulcrum supported 260 care services in 2023 alone. This extensive engagement has provided us with a comprehensive view of the challenges faced by the health and social care sector, particularly in the post-pandemic period, and more recently under CQC’s new ‘single assessment framework’.
‘In the past year, in the run up to and post the introduction of CQC’s new inspection framework, the health and social care sector has experienced significant upheaval. While the framework aims to streamline inspections and improve care quality, it has also led to increased scrutiny and pressure on health and social care providers. The new system, intended to be more flexible and data-driven, has instead resulted in confusion and fear among providers, leading to a punitive environment rather than a supportive one.
‘At Fulcrum Care, we have seen firsthand the devastating impact of CQC’s approach, not just on care providers, but also on the grossly under-reported impact on people who use health and social care services, their families and staff. We successfully prevented the closure of 32 care services last year, many of which were subject to enforcement actions that we believe were disproportionate. The overly stringent enforcement has not only placed undue stress on providers but has also driven many out of the sector, exacerbating an already critical shortage of high-quality health and social care services.
‘We call for a more balanced approach from the regulator, whether in current form as CQC, or as is likely to happen, a reinvented form of it under a different guise. We would also call other associated agencies which work with health and social care providers who look after vulnerable people to support improvement through collaboration rather than punitive actions. The health and social care sector needs an environment where providers feel supported and encouraged to meet high standards, not one where fear of retaliation looms over every inspection.’
Image: Hush Naidoo Jade Photography
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