Review of UK health watchdog CQC flags internal lapses

The report shows inspection rates have not returned to pre-pandemic levels, issues with CQC’s IT infrastructure, among other issues.

Soumya Sharma July 29 2024

An independent review has exposed 'significant internal failings' within the Care Quality Commission (CQC), affecting its ability to monitor healthcare services effectively across the UK.

Spearheaded by North West London Integrated Care Board chair Dr Penny Dash, the interim report highlights several critical issues at CQC.

The findings reveal that inspection rates have not returned to pre-pandemic levels, shortage of clinical expertise among inspectors, inconsistencies in assessments, as well as problems with IT infrastructure at CQC.

These shortcomings are impeding CQC's capacity to consistently evaluate the quality of health and care services, particularly those requiring urgent improvements.  

Additionally, the report indicates that social care providers face excessive delays in receiving updated registrations and ratings, impacting local service availability. 

The UK Department of Health and Social Care Secretary Wes Streeting has warned that as CQC is 'not fit for purpose', immediate action needs to be implemented to restore the public’s confidence in the country’s health system.

Streeting said: “We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.

“I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care. I want to reassure them that I am determined to grip this crisis and give people confidence that the care they’re receiving has been assessed.”

In response to these findings, the government has committed to immediate actions, including increasing oversight of CQC and implementing recommendations from Dash's final report, due in autumn 2024. 

Streeting has outlined four immediate measures, including the appointment of Sir Mike Richards, a former hospital physician and CQC's inaugural hospital chief inspector, to reassess CQC's evaluation frameworks. 

Further steps include enhancing the transparency of CQC's rating process, augmenting government supervision of CQC, and commissioning Dash to assess the efficacy of all patient safety organisations. 

Dash's review, initiated in May 2024, involved consultations with approximately 200 health and care sector professionals and over 50 senior managers and advisors at CQC.  

Preliminary findings point to a lack of relevant experience among some inspectors, with reports of inspectors unfamiliar with hospital settings or encountering patients with dementia for the first time. 

Additionally, it was estimated that one in five locations under CQC's jurisdiction have never been rated, and some organisations have not been re-inspected for years.

The oldest rating for an NHS hospital dates back over ten years and for a social care provider to 2015. 

To restore its credibility, Dash recommends that CQC urgently overhaul its inspection and assessment processes, improve operational performance, and rectify IT system issues. 

Dash's interim report comes shortly after Streeting ordered an independent investigation into the NHS.

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